Perceptions of pain control by consumers with chronic kidney disease

Aims and objectives.  This study investigated the perceptions of consumers with chronic kidney disease in relation to their pain control, the barriers and enablers to effective pain control, and how they made decisions in relation to their pain control. Background.  Consumers with chronic kidney disease are likely to experience pain as a consequence of their kidney disease, comorbidities, treatment and complications which is in need of investigation. Methods.  Twenty consumers were recruited from two metropolitan hospitals in Australia in 2007. Structured interviews and medical record review was conducted to gain an understanding of analgesic use and the facilitators and barriers to effective pain control in chronic kidney disease. Results.  The consumers’ mean age was 70 years. Consumers had a median of seven chronic health conditions, and multiple sources of acute and chronic pain. Athematic analysis of the interviews revealed five themes, which included the complexity of pain, pain relief approaches, ineffective pain control, limited analgesic options, and health professional factors. Conclusions.  Consumers in this study regularly experienced pain that averaged 6·7 on the numerical pain rating scale that was unrelieved with medically recommended analgesic regimens. Chronic pain was harder to control because of its unrelenting nature and the nephrotoxic risk of analgesic medicines. Consumers’ concomitant chronic health problem, interfered with what analgesia the consumers could be prescribed to relieve pain. General Practitioners were most frequently consulted for pain control rather than medical specialists. Consumers were prescribed a median of nine different medicines per day which influenced their approach to pain relief. Relevance to clinical practice.  Consumers with chronic kidney disease require guidance to help them to manage their pain effectively. Prescribers concerned about analgesics’ nephrotoxic risk need to carefully consider the consumer’s everyday quality of life when managing pain. Educational strategies to improve consumers’ pain management practices in collaboration with health professionals are warranted.