Correlates of satisfaction with pain treatment in the acute postoperative period: Results from the international PAIN OUT registry

Abstract

Patient ratings of satisfaction with their postoperative pain treatment tend to be high even in those with substantial pain. Determinants are poorly understood and have not previously been studied in large-scale, international datasets. PAIN OUT, a European Union-funded acute pain registry and research project, collects patient-reported outcome data on postoperative day 1 using the self-reported International Pain Outcome Questionnaire (IPO), and patient, clinical, and treatment characteristics. We investigated correlates of satisfaction and consistency of effects across centres and countries using multilevel regression modelling. Our sample comprised 16,868 patients (median age 55 years; 55% female) from 42 centres in 11 European countries plus Israel, USA, and Malaysia, who underwent a wide range of surgical procedures, for example, joint, limb, and digestive tract surgeries. Median satisfaction was 9 (interquartile range 7-10) on a 0-10 scale. Three IPO items showed strong associations and explained 35% of the variability present in the satisfaction variable: more pain relief received, higher allowed participation in pain treatment decisions, and no desire to have received more pain treatment. Patient factors and additional IPO items reflecting pain experience (eg, worst pain intensity), pain-related impairment, and information on pain treatment added little explanatory value, partially due to covariate correlations. Effects were highly consistent across centres and countries. We conclude that satisfaction with postoperative pain treatment is associated with the patients' actual pain experience, but more strongly with impressions of improvement and appropriateness of care. To the degree they desire, patients should be provided with information and involved in pain treatment decisions.

PAIN OUT: The making of an international acute pain registry

“…Interestingly, this was the only PRO that yielded a clinically relevant effect size in the current study, indicating perhaps, the increasing role of patient participation in health care. In a recent publication assessing a cohort of patients from PAIN OUT, participation in decisions about treatment was one of the three PROs, along with degree of relief received and no desire to receive more treatment, which strongly influenced satisfaction with pain treatment (Schwenkglenks et al, 2014). PROs in pain studies have highly skewed, nonnormal distributions.…”

Comparison of the Efficacy and Safety of Different Doses of Propacetamol for Postoperative Pain Control after Breast Surgery

“…Therefore, the pain experience may be different from that in our patients (Girard-Tremblay, et al, 2014). Another report indicated that the most severe pain experience was 2 hours after surgery (Schwenkglenks, et al, 2014), and the last pain evaluation time (4 hours after surgery) may be too short to discriminate the effects of different doses of propacetamol. In the present study, the time to request rescue analgesic was about 80 minutes after surgery, which was in accordance with results from the previous study (2 hours).…”

Comparative study of pain in women submitted to conventional laparoscopic cholecystectomy versus single-port laparoscopic cholecystectomy

“…In this respect, it is important to characterize the pain experience in all its domains, to assess the impact of pain on organic, emotional and behavioral functioning of the individual, to identify factors that contribute to the maintenance or exacerbation of pain, to select treatment alternatives, and to verify the effectiveness of the therapies employed. Systematically conducted and recorded assessments, which use specific scales to characterize and measure the pain condition, may contribute to improve the management of the painful experience 9 . Laparoscopy was introduced in 1987 and has since then been used for multiple intraabdominal procedures because of the reduced patient discomfort, shorter hospitalization time and early return to work 10 .…”