The influence of involving patients in postoperative pain treatment decisions on pain-related patient-reported outcomes: A STROBE-compliant registering observational study

Bailin Jiang, Yaqing Wu, Xiuli Wang, Yu Gan, Peiyao Wei, Weidong Mi, Yi Feng, Bailin Jiang, Yaqing Wu, Xiuli Wang, Yu Gan, Peiyao Wei, Weidong Mi, Yi Feng

Abstract

The evidence regarding the influence of allowing patients to participate in postoperative pain treatment decisions on acute pain management is contradictory. This study aimed to identify the role of patient participation in influencing pain-related patient-reported outcomes (PROs). This is a cross-sectional study. The data were provided by PAIN OUT (www.pain-out.eu). A dataset specific to adult Chinese patients undergoing orthopedic surgery was selected. The PROs were assessed on postoperative day 1. The patient participant was assessed using an 11-point scale. Participants who reported >5 were allocated to the "participation" group, and those who reported ≤5 were allocated to the "nonparticipation" group. A 1:1 propensity score matching was conducted. The primary outcome was the desire for more pain treatment. All other items of PROs were the secondary outcomes comprising pain intensity, interference of pain with function, emotional impairment, adverse effects, and other patient perception. From February 2014 to November 2020, 2244 patients from 20 centers were approached, of whom 1804 patients were eligible and 726 pairs were matched. There was no significant difference between the groups in the desire for more pain treatment either before (25.4% vs 28.2%, risk ratio [95% CI]: 0.90 [0.77, 1.05], P = .18) or after matching (26.7% vs 28.8%, risk ratio [95% CI]: 0.93 [0.79, 1.10], P = .43). After matching, patients in the participation group reported significantly better PROs, including pain intensity (less time spent in severe pain [P < .01]), emotional impairment (less anxiety [P < .01]), interference with function (less interference with sleep [P < .01]), adverse effects (less drowsiness [P = .01]), and patient perception (more pain relief [P < .01] and more satisfaction [P < .01]), than the nonparticipation group. Patient participation in pain treatment decisions was associated with improved pain experience but failed to mitigate the desire for more treatment.

Trial registration: ClinicalTrials.gov NCT02083835.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
Flow chart of the patients included in this study.
Figure 2.
Figure 2.
The desire for more pain treatment adjusted for other patient-reported outcomes. Pain intensity: worst pain, least pain, time spent in severe pain; emotional impairment: anxiety, helplessness; interference with function: breathing deeply or coughing, activities in bed, sleep; adverse effects: dizziness, drowsiness, itch, nausea; other patient perception: pain relief, satisfaction, receipt of information. CI = confidence interval, RR = risk ratio.

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Source: PubMed

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