2013-10-14 15:07:33 -
Pain in Europe VIII – 8th EFIC Congress, 9–12 October 2013, Florence
An approach to the management of postoperative pain in keeping with clinical practice guidelines does not always lead to better outcomes. This was the conclusion reached with data from the international acute pain registry PAIN OUT, presented at the Congress of the European Pain Federation EFIC in Florence.
Florence, 10 October 2013 – Even if postoperative pain is correctly managed as recommended by clinical practice guidelines, this does not necessarily mean a positive effect for patients. That is indicated in any case by data from the international acute pain registry PAIN OUT presented at the Congress of the European Pain Federation EFIC in Florence.
Project Director Prof Winfried Meissner from
the University Clinic of Jena: “Clinical practice guidelines are an important instrument for providing health care practitioners with a foundation for decision-making based on scientific evidence and for improving treatment outcomes. The interesting question is whether acting in adherence with clinical practice guidelines in heterogeneous groups of patients actually is reflected in better outcomes.”
This question can be only partially confirmed according to the PAIN OUT study presented in Florence. A total of 6,347 patients in eleven medical centres in Europe and Israel undergoing orthopaedic or general surgery provided patient reported outcomes (PROs). Specifically, they were asked whether they felt they had participated sufficiently in the decision on pain therapy and about the intensity of the pain they had experienced. At the same time, patients were asked whether they had received information about postoperative pain therapy options and whether the nursing staff had assessed and documented their pain status—both practices recommended in guidelines.
Two thirds of the patients said after the operation that they had been informed before the surgery about pain therapy options and three quarters said their postoperative pain had been assessed and recorded by nursing staff.
Prof Meissner said in connection with the outcome that the assessment was mixed: “Patients who had received information also indicated more frequently that they felt they were participating adequately in the treatment decision. There was a definite correlation in this case between practice and outcome. The pain documentation, for its part, had no definite positive effect on the intensity of pain. Recommendations from the guidelines are therefore not so easy to transfer to everyday treatment situations.” Besides implementing guideline recommendations, it is therefore always important to measure the quality of the outcomes—an easy task with PAIN OUT in the area of pain therapy.
PAIN-OUT (Improvement in postoperative PAIN OUTcome) is an EU-funded project aimed at optimising the treatment of postoperative pain. It is run by pain specialists at the University Clinic of Jena together with 17 cooperation partners in nine countries. To date, it has gathered data from 35,000 patients. More than 60 clinics from all continents have become affiliated with the project.
Source: EFIC Abstract Zaslansky et al, Implementation of clinical practice guidelines and patient reported outcomes: preliminary data from PAIN OUT, an international acute pain registry
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