Evaluation of inpatient postpartum recovery using the Obstetric Quality of Recovery-10 patient-reported outcome measure: a single-center observational study

Sultan, Pervez; Kamath, Nikhil; Carvalho, Brendan; Bansal, Prannal; Elkhateb, Rania; Dougan, Scott T.; Whittington, Julie R; Guo, Nan; El‐Sayed, Yasser Y.; Mhyre, Jill M.; Sharawi, Nadir

doi:10.1016/j.ajogmf.2020.100202

Cited by 40 publications

(37 citation statements)

References 21 publications

(17 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…Finally, during the Round 3 discussion, members of the Delphi group acknowledged that postpartum recovery is a multidimensional construct, which led to the inclusion of a validated composite patient-reported outcome measure of obstetric recovery (the Obstetric Quality of Recovery-10). 3,4,[28][29][30][31] Before introducing an enhanced recovery after cesarean delivery protocol, centers can consider developing the infrastructure required to capture some of the key outcomes proposed in this study in real-time during routine clinical care, without the need for additional research or administrative support. This process may involve the use of electronic healthcare records, and training of nursing staff to document times for key outcomes such as mobilization and urinary catheter removal.…”

Section: Perioperative Medicinementioning

confidence: 99%

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Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

et al. 2022

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Background Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delivery studies. Methods An international consensus study involving physicians, patients and a director of Midwifery and Nursing Services, was conducted using a three-round modified Delphi approach (2 rounds of electronic questionnaires and a 3rd round e-discussion), to produce the core outcome set. An initial list of outcomes was based on a previously published systematic review. Consensus was obtained for the final core outcome set, including definitions for key terms, and preferred units of measurement. Strong consensus was defined as ≥70% agreement and weak consensus as 50–69% agreement. Of the 64 stakeholders who were approached, 32 agreed to participate. All 32, 31 and 26 stakeholders completed Rounds 1, 2 and 3, respectively. Results The number of outcomes in the final core outcome set was reduced from 98 to 15. Strong consensus (≥70% stakeholder agreement) was achieved for 15 outcomes. The core outcome set included: length of hospital stay; compliance with enhanced recovery protocol; maternal morbidity (hospital re-admissions or unplanned consultations); provision of optimal analgesia (maternal satisfaction, compliance with analgesia, opioid consumption / requirement and incidence of nausea or vomiting); fasting times; breastfeeding success; and times to mobilization and urinary catheter removal. The Obstetric Quality of Recovery-10 item composite measure was also included in the final core outcome set. Areas identified as requiring further research included readiness for discharge and analysis of cost savings. Conclusions Results from an international consensus to develop a core outcome set for enhanced recovery after cesarean delivery are presented. These are outcomes that could be considered when designing future enhanced recovery studies.

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Section: Discussionmentioning

confidence: 99%

Section: Perioperative Medicinementioning

confidence: 99%

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

et al. 2022

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“…However, ObsQoR-11 has been updated to ObsQoR-10 by combining severe and moderate pain items, based on the patient feedback. ObsQoR-10 has been validated following spontaneous, instrumental, vaginal, and cesarean delivery in multiple healthcare setting [ 18 , 147 , 148 ]. However, more studies are needed to validate translated versions and determine minimal important clinical change and clinically significant differences in scores.…”

Section: Special Concerns About Pain Control In Cesarean Deliverymentioning

confidence: 99%

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Sangkum

Thamjamrassri

Arnuntasupakul

et al. 2021

Anesthesiology Research and Practice

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Optimal postoperative analgesia has a significant impact on patient recovery and outcomes after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery and pain management. For a standard analgesic regimen, the use of long-acting neuraxial opioids (e.g., morphine) and adjunct drugs, such as scheduled acetaminophen and nonsteroidal anti-inflammatory drugs, is recommended unless contraindicated. Oral or intravenous opioids should be reserved for breakthrough pain. In addition to the aforementioned use of multimodal analgesia, preoperative evaluation is critical to individualize the analgesic regimen according to the patient requirements. Risk factors for severe postoperative pain or analgesia-related adverse effects will require modifications to the standard analgesic regimen (e.g., the use of ketamine, gabapentinoids, or regional anesthetic techniques). Further investigation is required to determine analgesic drugs or dose alterations based on preoperative predictions for patients at risk of severe pain. Outcomes beyond pain and analgesic use, such as functional recovery, should be determined to evaluate analgesic treatment protocols.

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“…Patient-reported outcome measures (PROMs), structured questionnaires enabling patients to report their health status, are now widely regarded as the gold standard means of assessing recovery following surgery. 8 Although PROMs have been developed and validated to assess inpatient postpartum recovery, 7 , 9 , 10 , 11 , 12 , 13 to our knowledge, there is currently no consensus regarding which PROM optimally measures the quality of recovery for outpatient postpartum women. 14 , 15 Systematic review and psychometric analysis of available PROMs may help inform clinicians and researchers regarding whether a suitable measure exists that is capable of adequately assessing outpatient postpartum recovery.…”

Section: Introductionmentioning

confidence: 99%

Use of Patient-Reported Outcome Measures to Assess Outpatient Postpartum Recovery

et al. 2021

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IMPORTANCE Outpatient postpartum recovery is an underexplored area of obstetrics. There is currently no consensus regarding which patient-reported outcome measure (PROM) clinicians and researchers should use to evaluate postpartum recovery. OBJECTIVE To evaluate PROMs of outpatient postpartum recovery using Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. EVIDENCE REVIEW An initial literature search performed in July 2019 identified postpartum recovery PROMs and validation studies. A secondary search in July 2020 identified additional validation studies. Both searches were performed using 4 databases (Web of Science, Embase, PubMed, and CINAHL), with no date limiters. Studies with PROMs evaluating more than 3 proposed outpatient postpartum recovery domains were considered. Studies were included if they assessed any psychometric measurement property of the included PROMs in the outpatient postpartum setting. The PROMs were assessed for the following 8 psychometric measurement properties, as defined by COSMIN: content validity, structural validity, internal consistency, cross-cultural validity and measurement invariance, reliability, measurement error, hypothesis testing, and responsiveness. Psychometric measurement properties were evaluated in each included study using the COSMIN criteria by assessing (1) the quality of the methods (very good, adequate, doubtful, inadequate, or not assessed); (2) overall rating of results (sufficient, insufficient, inconsistent, or indeterminate); (3) level of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations assessment tool; and (4) level of recommendation, which included class A

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Evaluation of inpatient postpartum recovery using the Obstetric Quality of Recovery-10 patient-reported outcome measure: a single-center observational study

Cited by 40 publications

References 21 publications

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

The Current Consideration, Approach, and Management in Postcesarean Delivery Pain Control: A Narrative Review

Use of Patient-Reported Outcome Measures to Assess Outpatient Postpartum Recovery

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