(Stroke. 1997;28:1867-1870.)
© 1997 American Heart Association, Inc.
Articles |
Differences in Pain Medication Use in Stroke Patients With Aphasia and Without Aphasia
From the Jewish Rehabilitation Hospital Research Center (E.K., N.K.-B., R.B., S.R.), Speech and Language Pathology (F.S.), Nursing (M.L.), Adult Education (P.G.), Laval, Quebec; and McGill University, Department of Linguistics (E.K.), and School of Physical and Occupational Therapy (N.K.-B.), Montreal, Quebec, Canada.
Correspondence to Dr Eva Kehayia, PhD, Jewish Rehabilitation Hospital, 3205 Place Alton Goldbloom, Laval, Quebec, Canada H7V 1R2. E-mail inek{at}musicb.mcgill.ca
Background and Purpose While individuals with stroke are known to experience pain for a variety of reasons including premorbid conditions and stroke-specific sequelae, there are some groups of individuals with stroke, who because of aphasia, are unable to express their pain. This study investigated whether there exists an association between severity of aphasia and overall pain medication use as indicated (1) by the proportion of individuals medicated according to aphasia severity and (2) by the dosage of pain medication used according to aphasia severity.
Methods The study involved a retrospective chart review of 207 charts of patients with stroke admitted to the Jewish Rehabilitation Hospital (JRH), Laval, Canada. Patients were classified into three groups according to level of expressive aphasia: those without aphasia, those with mild-to-moderate aphasia, and those severe aphasia. Information on medications used primarily for pain management was elicited for the first 21 days and the last 5 days of hospitalization. Any substitution, increase, elimination, or addition of pain medication during hospitalization was also monitored.
Results and Conclusions While the findings indicate that pain medication prescriptions were similar for all patients, a significantly smaller number of individuals with aphasia received pro re nata (prn) "as required" pain medication when compared with those without aphasia, for the first 21 days and for the last 5 days of hospitalization at the JRH. Similarly, when daily dose was monitored for the same time periods, individuals with aphasia were found to have received less medication for pain than those without aphasia.
Key Words: cerebrovascular disorders • aphasia • pain
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