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Correlates of satisfaction with pain treatment in the acute postoperative period: Results from the international PAIN OUT registry

Schwenkglenks, Matthiasa,*; Gerbershagen, Hans J.b; Taylor, Rod S.c; Pogatzki-Zahn, Estherd; Komann, Marcuse; Rothaug, Judithe; Volk, Thomasf; Yahiaoui-Doktor, Maryamg; Zaslansky, Ruthe; Brill, Silviuh; Ullrich, Kristini; Gordon, Debra B.j; Meissner, Winfriede

doi: 10.1016/j.pain.2014.04.021
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Summary In an international cohort of surgical patients, satisfaction was strongly influenced by pain relief received, no desire to have received more pain treatment, and more allowed participation in pain treatment decisions.

ABSTRACT Patient ratings of satisfaction with their postoperative pain treatment tend to be high even in those with substantial pain. Determinants are poorly understood and have not previously been studied in large-scale, international datasets. PAIN OUT, a European Union-funded acute pain registry and research project, collects patient-reported outcome data on postoperative day 1 using the self-reported International Pain Outcome Questionnaire (IPO), and patient, clinical, and treatment characteristics. We investigated correlates of satisfaction and consistency of effects across centres and countries using multilevel regression modelling. Our sample comprised 16,868 patients (median age 55 years; 55% female) from 42 centres in 11 European countries plus Israel, USA, and Malaysia, who underwent a wide range of surgical procedures, for example, joint, limb, and digestive tract surgeries. Median satisfaction was 9 (interquartile range 7–10) on a 0–10 scale. Three IPO items showed strong associations and explained 35% of the variability present in the satisfaction variable: more pain relief received, higher allowed participation in pain treatment decisions, and no desire to have received more pain treatment. Patient factors and additional IPO items reflecting pain experience (eg, worst pain intensity), pain-related impairment, and information on pain treatment added little explanatory value, partially due to covariate correlations. Effects were highly consistent across centres and countries. We conclude that satisfaction with postoperative pain treatment is associated with the patients' actual pain experience, but more strongly with impressions of improvement and appropriateness of care. To the degree they desire, patients should be provided with information and involved in pain treatment decisions.

aInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland

bDepartment of Anesthesiology and Intensive Care Medicine, University Medical Center Utrecht, Utrecht, Netherlands

cExeter Medical School, University of Exeter, Exeter, Devon, UK

dDepartment of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany

eDepartment of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany

fClinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, Saarland University Medical Center and Saarland University Faculty of Medicine, Saarland, Germany

gInstitute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany

hDepartment of Anesthesiology, Tel Aviv Medical Center, Tel Aviv, Israel

iDepartment of Anesthesiology, Barts Health NHS Trust, London, UK

jDepartment of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA

* Corresponding author. Address: Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, Basel CH-4054, Switzerland. Tel.: +41 61 267 19 49; fax: +41 61 267 19 48.

E-mail address:m.schwenkglenks@unibas.ch

Article history:

Received October 21, 2013

Received in revised form April 14, 2014

Accepted April 15, 2014

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2014 International Association for the Study of Pain
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