The Journal of surgical research · 2024
Real-Time Pain Control Education After Outpatient General Surgery: A Randomized Controlled Trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Lee William G, Amersi Farin F, Jain Monica, Cunneen Scott A, Burch Miguel, Phillips Edward, Chen Yufei
Аннотация
INTRODUCTION: Opioid-related morbidity and mortality continue to rise with surgery often serving as the first exposure to opioids for patients. Few interventions focus on real-time education in the outpatient setting while patients are experiencing pain. The effect of short-messaging service (SMS) surveys with real-time opioid-use education (SMSE) and without (SMS) on outpatient postoperative opioid use was studied.
METHODS: A double-blinded randomized controlled trial enrolled adults (≥18 y) who underwent outpatient general surgery procedures from January 1, 2020, to January 2, 2021. Participants received an automated daily SMS or SMSE for 10 d postoperatively. Primary outcomes included total opioid use in oral morphine equivalents (OMEs) and total pain scores. Data were gathered via real-time SMS patient responses.
RESULTS: One hundred sixty patients were randomized to SMS (n = 82) or SMSE (n = 78). Patient demographic/clinical characteristics and surgery type were similar. Between SMS and SMSE, there were no differences in total pain scores (25 [interquartile range (IQR): 25.0] versus 31 [IQR: 35.7], P = 0.291) or total OME used (15.5 mg [IQR: 37.5] versus 15.8 mg [IQR: 45.6], P = 0.762). Increased total OME correlated with younger age (P = 0.001), opioids prescribed (P = 0.001), and preoperative opioid use (P = 0.018). Higher patient satisfaction was observed in patients with lower total pain scores and OME used, with no difference in opioids prescribed (P = 0.352). Subgroup analysis revealed open hernia repair patients in the SMSE group had lower OME used (0 mg [IQR: 0] versus 14.2 mg [IQR: 11.6], P = 0.004).
CONCLUSIONS: Real-time opioid-use education via SMS did not lead to a difference in opioid use, but demonstrated a high acceptance rate as a mode of communication and feedback. This finding should encourage further optimization of the SMS tool to rapidly identify patients with inadequate pain control while promoting appropriate opioid use and disposal.
METHODS: A double-blinded randomized controlled trial enrolled adults (≥18 y) who underwent outpatient general surgery procedures from January 1, 2020, to January 2, 2021. Participants received an automated daily SMS or SMSE for 10 d postoperatively. Primary outcomes included total opioid use in oral morphine equivalents (OMEs) and total pain scores. Data were gathered via real-time SMS patient responses.
RESULTS: One hundred sixty patients were randomized to SMS (n = 82) or SMSE (n = 78). Patient demographic/clinical characteristics and surgery type were similar. Between SMS and SMSE, there were no differences in total pain scores (25 [interquartile range (IQR): 25.0] versus 31 [IQR: 35.7], P = 0.291) or total OME used (15.5 mg [IQR: 37.5] versus 15.8 mg [IQR: 45.6], P = 0.762). Increased total OME correlated with younger age (P = 0.001), opioids prescribed (P = 0.001), and preoperative opioid use (P = 0.018). Higher patient satisfaction was observed in patients with lower total pain scores and OME used, with no difference in opioids prescribed (P = 0.352). Subgroup analysis revealed open hernia repair patients in the SMSE group had lower OME used (0 mg [IQR: 0] versus 14.2 mg [IQR: 11.6], P = 0.004).
CONCLUSIONS: Real-time opioid-use education via SMS did not lead to a difference in opioid use, but demonstrated a high acceptance rate as a mode of communication and feedback. This finding should encourage further optimization of the SMS tool to rapidly identify patients with inadequate pain control while promoting appropriate opioid use and disposal.