The implementation of an electronic symptom management system to monitor postoperative pain in thoracic surgery patients: A multicenter evaluation.

OBJECTIVE

Few studies have evaluated postoperative recovery of patients after thoracic surgery using patient-reported outcome measures. This multi-institutional study analyzed postoperative pain and opioid use among patients undergoing thoracic surgery based on patient-reported outcome measures data collected through an electronic symptom management system.

METHODS

The electronic symptom management system is a multi-symptom questionnaire based on a Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events that is integrated into the electronic health record and administered via the patient portal. Patients undergoing lung resections were invited to complete electronic symptom surveys within the electronic symptom management system during their 90-day postoperative period. Baseline patient demographics, surgical data, and postoperative opioid data were gathered from the electronic health record. Multivariable hierarchical regression was used to evaluate predictors of postoperative pain and opioid prescriptions.

RESULTS

Of 680 patients who met the inclusion criteria, 258 (37.9%) reported at least 1 severe pain score. Patients reporting severe pain were more likely to have undergone open surgery, to receive at least 1 postoperative opioid prescription, and to become persistent opioid users compared with patients reporting no severe pain. In multivariable logistic regression analysis, the only factor associated with a severe pain score was female sex (odds ratio, 1.67, 95% CI, 1.17-2.39; P = .005).

CONCLUSIONS

This multicenter study used patient-reported outcome measures to evaluate predictors of postoperative pain and opioid prescriptions in patients undergoing thoracic surgery. Further investigation into the administration of patient-reported outcome measures is needed to assess their ability to impact postsurgical care and postoperative outcomes.