An international research group with members from the University of Basel, several EU countries, Israel and the USA, analyzed patient satisfaction with pain treatment after surgery. The study based on an extensive multi-national dataset shows that patients actively involved in their treatment report higher levels of satisfaction. Overall, satisfaction seems to be less associated with actual pain but rather with impressions of improvement. The scientific journal “PAIN” has published the results.

Every year, millions of surgeries are performed. At least half of the patients suffer from moderate to severe pain after surgery. Well managed postoperative pain is thus an important quality criterion for healthcare providers. Even though previous studies have shown that patient ratings of satisfaction with their pain treatment tend to be high, the determinants for this effect are poorly understood and have previously not been studied in large-scale, international datasets.

PAIN OUT registry
For their analysis, the research team led by Dr. Matthias Schwenkglenks from the Institute of Pharmaceutical Medicine used PAIN OUT, an EU-funded, international acute pain registry and research project that collects patient-reported outcome data on day 1 after surgery. Patients use a standardized questionnaire for self-completion. PAIN OUT offers a system for measurement and feedback of outcome quality and supports the process of decision making in order to achieve an optimized treatment of patients.

Schwenkglenks and his team used this large database to investigate patients’ level of satisfaction across more than 40 healthcare centers in 15 countries. The study included roughly 16,900 patients from three continents who had undergone a wide range of surgical procedures. The analysis showed three aspects to be most important for patient satisfaction: pain experience, patient involvement and characteristics of the patient-caregiver relationship (e.g. provision of adequate information on pain treatment options). “We were the first research group that was able to study this topic at such a large scale, a unique opportunity. It was striking to us how consistent our results were across healthcare centers and countries”, states Schwenkglenks.

Expanding patient involvement

Overall, the findings indicate that satisfaction with postoperative pain treatment is less associated with the patients’ actual pain experience but rather with impressions of improvement and appropriateness of care. Specifically, the area of patient involvement in the decision making process seems to be of high importance. The study thus suggests that in the effort to manage pain effectively, it would be inappropriate to focus on low pain intensity as the only goal of postoperative pain treatment. Patients should, to the degree they desire, be provided with information and involved in pain treatment decisions.

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Original source

Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, Volk T, Yahiaoui-Doktor M, Zaslansky R, Brill S, Ullrich K, Gordon DB, Meissner W.
Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry.
PAIN 2014; 155,| DOI: 10.1016/j.pain.2014.04.021

[The PAIN OUT project was funded by the European Commission 7th Framework Programme, Call HEALTH-2007-3.1-4: Improving clinical decision making, under Grant Agreement No. 223590.]

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Olivia Poisson
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University of Basel