Pain intensity and pain self-management strategies following discharge after surgery: An Australian prospective observational study

Abstract

SummaryWhat is known and objective: Up to 80% of patients experience acute pain following surgery. This study aimed to improve the current understanding about the strategies individuals use to self-manage pain following discharge after surgery, stratified by pain intensity. Methods What is new and conclusion:A high proportion of patients underused analgesics despite experiencing moderate-severe pain. Although the vast majority of participants reported receiving advice regarding pain self-management, this did not appear to translate into optimal pain management after discharge. Different approaches to the provision of advice appear to be required. K E Y W O R D Sdrug information, pain, self-care, self-medication | WHAT IS KNOWN AND OBJECTIVEUp to 80% of patients undergoing a surgical procedure requiring an incision will experience acute post-operative pain.1 Uncontrolled acute post-operative pain has the potential to reduce participation in rehabilitation activities and increase the risk of persistent post-operative pain (PPP) and venous thromboembolism, as well as increasing the likelihood of readmission to hospital or extending the length of the initial hospital admission. 2-7In hospital, pain is carefully managed in the peri-and postoperative phase by a multidisciplinary team. However, pain relief in the period following discharge from hospital is less structured and

Pain control and related factors in hospitalized patients

“…It showed that patients may still have pain when they were discharged from the hospital after undergoing invasive treatment or surgery, and the incidence of pain at discharge is as high as 46.5%. This result is similar to the Veal et al [7] study. That study showed that although most patients had received recommendations on pain self-management, 47.3% of patients still reported moderate to severe pain after discharge, and it is recommended that individualized pain management is needed to optimize patient pain care.…”

“…The lack of proper pain management causes the pain problem to persist until after discharge from hospital. [ 6 , 7 ] The pain can even last for more than 3 months and becomes a newly added chronic pain, which affects the patient's quality of life, employment, and sleep. [ 4 , 8 ] It also causes patients to seek medical treatment repeatedly, which indirectly leads to huge increases in costs to the healthcare system.…”

“…Andersson et al [4] found that 29% of hospitalized patients reported moderate to severe pain during rest and 41% reported moderate to severe pain during activity. The lack of proper pain management causes the pain problem to persist until after discharge from hospital [6,7] . The pain can even last for more than 3 months and becomes a newly added chronic pain, which affects the patient's quality of life, employment, and sleep [4,8] .…”

Inpatient postoperative undesirable side effects of analgesics management: a pediatric patients and parental perspective

“… 18 , 27 Patients and parents should be knowledgeable about analgesic use and the risk for side effects in the weeks before surgery and their concerns should continuously be addressed thereafter by the same team to avoid them forgetting information and to ensure correct and consistent education. 26 Prescribing antiemetics based on the reason for symptoms and administering prophylactic treatment to patients is frequent. 4 , 28 However, parents and patients may not be comfortable with the consumption of additional medications; therefore, clinicians should also educate patients on nonpharmacological strategies for pain management and side effects.…”

Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand

“…Acute pain is one of the most common reasons why patients seek treatment at an emergency department, and remains a common problem in the post-operative setting [ 3 – 6 ] . In a recent Australian study, 47% of patients experienced moderate-to-severe pain 1 week after surgery [ 7 ]. Pain is common, but often poorly managed following cancer treatment with an estimated prevalence rate for certain types of cancer from 29% to 57% [ 8 , 9 ].…”