The effect of a pain management program on the rehabilitation of elderly patients following hip fracture surgery

Background: Pain following hip fracture and internal fixation is a major factor during the treatment of elderly patients on rehabilitation programs. A proactive pain management program was instituted in our geriatric rehabilitation ward in 2005. Objectives: To compare retrospectively two groups of patients, one before and one after implementation of the proactive pain management program. Methods: The study group comprised 67 patients and the control group 77 patients. Pain in the study group was evaluated daily by the visual analogue scale (VAS) and the outcome of the rehabilitation process by the Functional Independence Measure (FIM). During the study period (2003-2006) no changes were made in the rehabilitation team, methods or facilities other than introduction of the pain control program. We compared the FIM scores between admission and discharge in both groups. Results: Improvement in FIM scores between admission and discharge was significantly higher in the study group than in the control group (11.07 ± 7.9 vs. 8.4 ± 7.3, P < 0.03). There was no significant difference between the average lengths of stay. Conclusions: These data support the view that the proactive monitoring of pain in surgical hip fracture patients is associated with a better outcome of the rehabilitation process.