BACKGROUND: Optimal treatment for acute pain is a function of an individual's willingness to make trade-offs between treatment side effects and pain control. The objective was to investigate the degree to which patients are willing to make these trade-offs. METHODS: Fifty patients undergoing major abdominal surgery were enrolled and completed interviews before and after surgery. Measures included an experience with pain questionnaire and an adaptive conjoint analysis (ACA) interview. RESULTS: Percentage of pain relief obtained post-surgery was between 70 and 80%. Eight-two per cent reported at least one moderate or severe side effect. ACA results demonstrated that pain efficacy and side effect type/severity have almost equal 'importance' scores. Patients varied in their willingness to trade-off pain efficacy for different or milder side effects. CONCLUSIONS: We conclude that people have different relative preferences for different side effects and are willing to trade-off pain relief for less upsetting and/or less severe side effects but to different degrees. Thus, physicians should consider offering pain medications with fewer side effects than narcotics as a first choice. Our study indicates the need to balance analgesia and side effects in order for patients to achieve optimal pain control.
BACKGROUND: Optimal treatment for acute pain is a function of an individual's willingness to make trade-offs between treatment side effects and pain control. The objective was to investigate the degree to which patients are willing to make these trade-offs. METHODS: Fifty patients undergoing major abdominal surgery were enrolled and completed interviews before and after surgery. Measures included an experience with pain questionnaire and an adaptive conjoint analysis (ACA) interview. RESULTS: Percentage of pain relief obtained post-surgery was between 70 and 80%. Eight-two per cent reported at least one moderate or severe side effect. ACA results demonstrated that pain efficacy and side effect type/severity have almost equal 'importance' scores. Patients varied in their willingness to trade-off pain efficacy for different or milder side effects. CONCLUSIONS: We conclude that people have different relative preferences for different side effects and are willing to trade-off pain relief for less upsetting and/or less severe side effects but to different degrees. Thus, physicians should consider offering pain medications with fewer side effects than narcotics as a first choice. Our study indicates the need to balance analgesia and side effects in order for patients to achieve optimal pain control.
Authors: Daniel S Tsze; Gerrit Hirschfeld; Carl L von Baeyer; Leonor E Suarez; Peter S Dayan Journal: Acad Emerg Med Date: 2019-02-19 Impact factor: 3.451
Authors: A Brett Hauber; Ateesha F Mohamed; F Reed Johnson; Olatoye Oyelowo; Bradley H Curtis; Cheryl Coon Journal: Qual Life Res Date: 2010-03-04 Impact factor: 4.147
Authors: F Reed Johnson; George Van Houtven; Semra Ozdemir; Steve Hass; Jeff White; Gordon Francis; David W Miller; J Theodore Phillips Journal: J Neurol Date: 2009-04-27 Impact factor: 4.849