PAIN OUT: an international acute pain registry supporting clinicians in decision making and in quality improvement activities

Abstract

PAIN OUT, a large, growing international registry, allows use of 'real-life' data related to management of perioperative pain. Ultimately, comparative analysis through audit, feedback and benchmarking will improve quality of care.

Chronic postsurgical pain in Europe

“…[5][6][7][8] The participating centres in 11 different European countries were able to collect prospective data from 889 patients 12 months after surgery using validated questionnaires. Data were collected without additional dedicated manpower through electronic communication, representing a new approach for a prospective European CPSP study.…”

“…[5][6][7] A standardised postoperative questionnaire has been developed, translated and validated in different European languages. 8 A collaboration between the PAIN OUT network and the European Society of Anaesthesiology (ESA) Clinical Trial Network provided an interesting opportunity to collect data on CPSP in a large European registry.…”

Development and Implementation of a Registry of Patients Attending Multidisciplinary Pain Treatment Clinics: The Quebec Pain Registry

“…Compared to the majority of existing pain patient registries [9–16], the QPR is somewhat unique in that it covers a wide variety of chronic pain disorders. Based on our literature review, there are only two other longitudinal registries which have been implemented in multidisciplinary pain treatment clinics, that is, the PACS [17] (also named PainDB [57]) and the CHOIR [18].…”

“…Patient registries can also be designed to (1) describe the progression of diseases, (2) monitor quality of care, (3) assess the cost-effectiveness of treatments, or (4) conduct outcome research studies [1–3]. Although they also have their limitations [1, 2, 4], patient registries represent interesting and alternative research avenues and are becoming more and more popular in subspecialities of pain medicine including management of acute postoperative pain (e.g., [9]), rheumatic diseases [10, 11], low back pain (e.g., [12]), and neuropathic pain (e.g., [13, 14]) as well as pain rehabilitation (e.g., [15]) and military-specific pain services (e.g., [16] to name just a few.…”

Current issues in postoperative pain management

“…Some of the key changes have been the change from intramuscular or subcutaneous to titrated doses of intravenous morphine administered by ward nurses on every surgical ward; patient information brochures in 16 languages and video; regular pain assessment at rest and on movement (every 3 h in awake patients) and documentation of pain scores; pain assessment tool changed to numerical rating scale from visual analogue scale; increase from one to three APS nurses (two of these part time) although the total number of operations decreased gradually from 20 000 to about 15 000 per year; annual audit feedback to surgeons and ward nurses; epidural PCA mode instead of continuous infusion to allow better mobilisation with 'walking epidural'; modified analgesic routines to adapt to surgical ERAS protocols; increased use of perineural techniques on surgical wards; electronic recording of pain scores; and the use of hand-held computers by APS nurses to prospectively collect audit data and joining the PAIN OUT international database for benchmarking of our APS. 111 The general principles of this APS model have been recommended for Swedish hospitals by the Swedish Medical Association (Svenska Läkaresällskapet) in 2001 112 and have also been implemented in several other countries. 2,109,113 This 'office hours only' APS nurse-based model does not provide direct hands-on patient care, nor does it provide out of hours cover.…”