Prevalence and Predictors of Patient Nonadherence to Pharmacological Acute Pain Therapy at Home After Day Surgery: A Prospective Cohort Study

Stessel, Björn; Theunissen, Maurice; Marcus, Marco A. E.; Joosten, Elbert A.J.; Kuijk, Sander M. J. van; Fiddelers, Audrey A. A.; Peters, Madelon L.; Hoofwijk, D.; Buhre, W.; Gramke, Hans-Fritz

doi:10.1111/papr.12589

Cited by 13 publications

(20 citation statements)

References 44 publications

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“…Furthermore, patients in the full adherence group were overall more satisfied with their medication than the non-adherence/partial adherence group, which was in line with our previously published results (14). Recently, we published the results of a prospective cohort study (n = 1248) assessing the prevalence of adherence to a treatment schedule for pain after ambulant surgery (14). We demonstrated a prevalence of respectively 21.60% and 20.00% of non-adherence and partial adherence to the treatment schedule after ambulant surgery (14).…”

Section: Discussionsupporting

confidence: 92%

“…We also found that women and patients with high baseline levels for pain and pain interference with social activities were underrepresented in the full-adherence group. Furthermore, patients in the full adherence group were overall more satisfied with their medication than the non-adherence/partial adherence group, which was in line with our previously published results (14). Recently, we published the results of a prospective cohort study (n = 1248) assessing the prevalence of adherence to a treatment schedule for pain after ambulant surgery (14).…”

Section: Discussionsupporting

confidence: 87%

“…Proper adherence to prescribed postoperative pain medication is a prerequisite to prevent the pain after ambulant surgery (14). Adherence is "the extent of similarity between the patient's actual dosage and the predefined schedule" (15).…”

Section: Introductionmentioning

confidence: 99%

“…The reasons for medication non-adherence are categorized into two groups: intentional and unintentional (16). Unintentional non-adherence can occur when a patient wants to follow the schedule but is prohibited due to a poor recall or financial issues (14,16). Intentional non-adherence can occur when the patient is deliberately not adhering to the treatment schedule because of fear of adverse effects (14,16).…”

Section: Introductionmentioning

confidence: 99%

“…Unintentional non-adherence can occur when a patient wants to follow the schedule but is prohibited due to a poor recall or financial issues (14,16). Intentional non-adherence can occur when the patient is deliberately not adhering to the treatment schedule because of fear of adverse effects (14,16). It has already been demonstrated that analgesic non-adherence and partial adherence after day surgery is rather common (14).…”

Section: Introductionmentioning

confidence: 99%

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Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

et al. 2020

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Background: Nowadays, complicated and painful surgical procedures are encouraged to be carried out in an ambulatory setting. Objectives: The current study aimed to assess 4-week postoperative pain profiles of 4 painful ambulatory surgical procedures. We analyzed the prevalence of and reasons for non-adherence and partial adherence of patients to a predefined treatment schedule after the ambulant surgery. Methods: The current study analyzed data from a large randomized trial by evaluating the effect of postoperative pain medication on acute postoperative pain at home during the first 4 postoperative days (POD) in patients scheduled for ambulatory hemorrhoid surgery, shoulder or knee arthroscopy, and inguinal hernia repair. Postoperative pain intensity was assessed at POD 0, 1, 2, 3, 4, 7, 14, and 28 via the Numeric Rating Scale (NRS). Adherence was assessed on POD 1, 2, 3, and 4. Results: Median average pain scores were above an NRS of 3 during the first postoperative week after shoulder arthroscopy and even above 4 during the first postoperative week after hemorrhoid surgery. 26% of patients undergoing shoulder arthroscopy and hemorrhoid surgery still had moderate pain 1 week after surgery. Median average pain scores were below an NRS of 3 during the whole study period after inguinal hernia repair and knee arthroscopy. 24.61% of patients did not use the study medication as prescribed, 5.76% of whom were non-adherent, and 18.85% were partially adherent. Conclusions: Each type of ambulant surgery has its unique postoperative pain profile. New strategies should be developed for pain therapy at home, particularly after the ambulatory arthroscopic shoulder surgery and hemorrhoid surgery. Non-adherence is uncommon if they are provided with a multimodal analgesic home kit together with clear verbal, written instructions, and intensive follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

et al. 2020

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Co-crystal of Tramadol-Celecoxib Versus Tramadol or Placebo for Acute Moderate-to-Severe Pain After Oral Surgery: Randomized, Double-Blind, Phase 3 Trial (STARDOM1)

Langford,

Pogatzki-Zahn,

Morte

et al. 2024

Adv Ther

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Introduction Co-crystal of tramadol-celecoxib (CTC) is the first analgesic co-crystal for acute pain. This completed phase 3 multicenter, double-blind trial assessed the efficacy and safety/tolerability of CTC in comparison with that of tramadol in the setting of moderate-to-severe pain up to 72 h after elective third molar extraction requiring bone removal. Methods Adults ( n = 726) were assigned randomly to five groups (2:2:2:2:1): orally administered twice-daily CTC 100 mg (44 mg rac -tramadol hydrochloride/56 mg celecoxib; n = 164), 150 mg (66/84 mg; n = 160) or 200 mg (88/112 mg; n = 160); tramadol 100 mg four times daily ( n = 159); or placebo four times daily ( n = 83). Participants in CTC groups also received twice-daily placebo. The full analysis set included all participants who underwent randomization. The primary endpoint was the sum of pain intensity differences over 0 to 4 h (SPID 0–4 ; visual analog scale). Key secondary endpoints included 4-h 50% responder and rescue medication use rates. Safety endpoints included adverse events (AEs), laboratory measures, and Opioid-Related Symptom Distress Scale (OR-SDS) score. Results All CTC doses were superior to placebo ( P < 0.001) for primary and key secondary endpoints. All were superior to tramadol for SPID 0–4 (analysis of covariance least squares mean differences [95% confidence interval]: − 37.1 [− 56.5, − 17.6], − 40.2 [− 59.7, − 20.6], and − 41.7 [− 61.2, − 22.2] for 100, 150, and 200 mg CTC, respectively; P < 0.001) and 4-h 50% responder rate. Four-hour 50% responder rates were 32.9% (CTC 100 mg), 33.8% (CTC 150 mg), 40.6% (CTC 200 mg), 20.1% (tramadol), and 7.2% (placebo). Rescue medication use was lower in the 100-mg ( P = 0.013) and 200-mg ( P = 0.003) CTC groups versus tramadol group. AE incidence and OR-SDS scores were highest for tramadol alone. Conclusions CTC demonstrated superior pain relief compared with tramadol or placebo, as well as an improved benefit/risk profile versus tramadol. Trial registration ClinicalTrials.gov identifier, NCT02982161; EudraCT number, 2016-000592-24. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02744-2.

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Acute Pain Management Following Mandibular Third Molar Exodontia: A Bibliometric Analysis of Randomized Controlled Trials

Huang,

Gan,

et al. 2024

International Dental Journal

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Prevalence and Predictors of Patient Nonadherence to Pharmacological Acute Pain Therapy at Home After Day Surgery: A Prospective Cohort Study

Cited by 13 publications

References 44 publications

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

Co-crystal of Tramadol-Celecoxib Versus Tramadol or Placebo for Acute Moderate-to-Severe Pain After Oral Surgery: Randomized, Double-Blind, Phase 3 Trial (STARDOM1)

Acute Pain Management Following Mandibular Third Molar Exodontia: A Bibliometric Analysis of Randomized Controlled Trials

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