Highlights
- •Pain intensity alone cannot fully capture the complexity of postsurgical pain.
- •Desire to receive more pain treatment is a helpful patient-reported outcome measure.
- •Desire to receive more pain treatment adds new perspective to pain treatment quality.
- •Patient information and participation decrease the need for pain treatment.
Abstract
Acute postoperative pain is frequently evaluated by pain intensity scores. However,
interpretation of the results is difficult and thresholds requiring treatment are
not well defined. Additional patient-reported outcome measures (PROMs) might be helpful
to better understand individual pain experience and quality of pain management after
surgery. We used data from the QUIPS pain registry for a cross-sectional study in
order to investigate associations between the desire to receive more pain treatment
(D2RMPT) with pain intensity ratings and other PROMs. Responses from 79,996 patients
were analyzed, of whom 10.7% reported D2RMPT. A generalized estimating equation Poisson
model showed that women had a lower risk ratio (RR) to answer this question with “yes”
(RR: .92, P < .001). Factors that increased the risk most were “maximal pain intensity ≥ 6/10 on
a numerical rating scale” (RR: 2.48, P < .001) and “any pain interference” (RR: 2.48, P < .001). The largest reduction in risk was observed if patients were “allowed to participate
in pain treatment decisions” (RR: .41, P < .001) and if they felt that they “received sufficient treatment information” (RR:
.58, P < .001). Our results indicate that the (easily assessed) question D2RMPT gives additional
information to other PROMs like pain intensity. The small proportion of patients with
D2RMPT (even for high pain scores) opens the discussion about clinicians’ understanding
of over- und under-treatment and questions the exclusive use of pain intensity as
quality indicator. Future studies need to investigate whether asking about D2RMPT
in clinical routine can improve postoperative pain outcome.
Perspective
This article presents characteristics of the patient-reported outcome measure “Desire
to receive more pain treatment.” This measure could be used to apply pain treatment
in a more individualized way and lead to improved treatment strategies and quality.
Key Words
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Article info
Publication history
Published online: January 19, 2021
Accepted:
January 3,
2021
Received in revised form:
December 16,
2020
Received:
October 20,
2020
Footnotes
Author contributions:
Marcus Komann: Idea, concept, data interpretation, writing, literature, approval
Phillip Baumbach: Concept, statistics, writing, tables and figures, literature, approval
Ulrike Stamer: Data interpretation, writing, literature, approval
Esther Pogatzki-Zahn: Data interpretation, writing, literature, approval
Claudia Weinmann: Concept, data interpretation, writing, language editing, approval
Christin Arnold: Data interpretation, writing, literature, approval
Winfried Meißner: Concept, data interpretation, writing, literature, approval
Disclosures
Funding: No funding was provided.
Conflict of interests:
Marcus Komann: None
Phillip Baumbach: None
Ulrike Stamer: Ulrike Stameer reports honoraria and reimbursement for travel costs from Syntetica and Grünenthal outside of the submitted work.
Claudia Weinmann: None
Christin Arnold: None
Esther Pogatzki-Zahn: Esther Pogatzki-Zahn reports (outside of the submitted work) grants from IMI2 PainCare project of EU, Mundipharma, Grünenthal, DFG, BMBF (all to her institution) and personal fees from Mundipharma, personal fees from Grünenthal (outside the submitted work).
Winfried Meißner: Winfried Meißner reports grants and personal fees from Grünenthal, grants from Pfizer, personal fees from TAD, personal fees from BioQPharm, personal fees from Bionorica, personal fees from Kyowa, personal fees from Northern Swan, grants from Mundipharma, personal fees from Tilray, outside the submitted work.
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
