Celeste A Lemay1, Kenneth G Saag2, Patricia D Franklin3. 1. University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: Celeste.lemay@umassmed.edu. 2. Department of Medicine, Center for Outcomes and Effectiveness Research and Education, Center for Education and Research on Therapeutics, Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 3. Musculoskeletal Center of Excellence, Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.
Abstract
BACKGROUND: The majority of patients undergoing total joint replacement (TJR) experience surgical pain in the early postoperative period and managing pain can be challenging for orthopedic surgeons and their patients. AIMS: The objective of this study was to better understand the postoperative pain management education needs of elective total joint replacement patients. DESIGN: This study had a descriptive phenomenological, qualitative design using individual interviews. SETTINGS: Nine orthopedic surgeons offices in 8 states. PARTICIPANTS/ SUBJECTS: Twenty-seven patients (mean age: 71 years; 74% female; 78% non-Hispanic white) completed the interview. METHODS: Patients were interviewed using open-ended questions, which included experiences with surgical pain after surgery and how it was managed, experiences with pain medicine, experience using non-medicine-related pain reduction methods, and suggestions for delivery of pain management information. RESULTS: Challenges identified for managing postoperative pain included loss of pain control and lack of information about prescribed opioids and nonopioid methods of managing pain. Facilitators included having a caregiver or family member in a health care field and previous experience managing postoperative pain. Participants believed that information about pain management would be helpful and should be delivered at multiple time points. CONCLUSIONS: With trends toward shorter hospital stays, as well as the growing opioid epidemic and the associated concerns regarding prescribing opioids, home-based pain management should be a priority. Interventions should include education about narcotic use and abuse as well as nonmedication approaches to pain management.
BACKGROUND: The majority of patients undergoing total joint replacement (TJR) experience surgical pain in the early postoperative period and managing pain can be challenging for orthopedic surgeons and their patients. AIMS: The objective of this study was to better understand the postoperative pain management education needs of elective total joint replacement patients. DESIGN: This study had a descriptive phenomenological, qualitative design using individual interviews. SETTINGS: Nine orthopedic surgeons offices in 8 states. PARTICIPANTS/ SUBJECTS: Twenty-seven patients (mean age: 71 years; 74% female; 78% non-Hispanic white) completed the interview. METHODS:Patients were interviewed using open-ended questions, which included experiences with surgical pain after surgery and how it was managed, experiences with pain medicine, experience using non-medicine-related pain reduction methods, and suggestions for delivery of pain management information. RESULTS: Challenges identified for managing postoperative pain included loss of pain control and lack of information about prescribed opioids and nonopioid methods of managing pain. Facilitators included having a caregiver or family member in a health care field and previous experience managing postoperative pain. Participants believed that information about pain management would be helpful and should be delivered at multiple time points. CONCLUSIONS: With trends toward shorter hospital stays, as well as the growing opioid epidemic and the associated concerns regarding prescribing opioids, home-based pain management should be a priority. Interventions should include education about narcotic use and abuse as well as nonmedication approaches to pain management.