Pain Management Information and Joint Arthroplasty
I notice the same thing in my area. Most patients have not had any pain management education. The education is at the level of the information on the narcotic bottle of how much to take and when to take.
It appears it is worthwhile to sit down and discuss not only pain management, but also what to expect with regard to pain post arthroplasty. Patients need to know about typical pain intensity levels, how long pain will last, how their days will change and how long it will be until they can sleep throughout the night without pain.
I'm not sure why physical outcomes are affected by pain management education. It seems it might be helpful to spend time educating about pain and pain expectations.
Here's a quick view of the abstract.
Receipt of Pain Management Information Preoperatively Is Associated With Improved Functional Gain After Elective Total Joint Arthroplasty.
Poorly controlled postoperative pain may adversely affect total joint arthroplasty (TJA) patients' outcomes and associated healthcare cost. Understanding effective pain management after surgery is important to patients, surgeons, and hospitals. We evaluated patient-reported receipt of preoperative pain management information in a national prospective cohort evaluating postoperative pain and function following elective TJA.
Preoperative and 2-week and 6-month postoperative survey data of 1609 TJA patients collected between June 2013 and December 2014 were analyzed. Data included demographics, medical and musculoskeletal comorbidity, operative joint pain, physical function, and mental health. At 2 weeks postoperative, patients were asked if they had received pain management information prior to surgery, the content of that education, and pain management strategies. Descriptive statistics were performed.
At 2 weeks post-TJA, one-third of patients reported not receiving information about pain management; an additional 11% did not find the information helpful. There were no differences preoperatively in demographics or clinical profiles between those who received pain information and those who did not. Patients who received pain information reported less pain 2 weeks postoperatively, greater use of non-narcotic pain care strategies, and better physical function scores at 6 months postoperatively. No differences in operative joint pain were identified at 6 months between education and noneducation groups.
Forty-four percent of the patients reported that they did not receive/received unhelpful information regarding postoperative pain management, highlighting a need for improved patient education. In this sample, the lack of pain management information was associated with poorer 6-month postoperative function.
J Arthroplasty. 2017 Jan 26. pii: S0883-5403(17)30060-8. doi: 10.1016/j.arth.2017.01.028. [Epub ahead of print]