Following a surgery, patients not only experience pain but often feel frightened and anxious as well. Now, an international research group that conducted a study analyzing patient satisfaction came to some surprising conclusions regarding post-operative pain treatments. First, they discovered that those patients who are actively involved in their own treatment report higher levels of satisfaction. More interesting, though, the researchers found that satisfaction levels mirrored patients’ impressions of their improvement after surgery, and had much less to do with the intensity of their actual pain. "We were the first research group that was able to study this topic at such a large scale, a unique opportunity,” noted Dr. Matthias Schwenkglenks of the Institute of Pharmaceutical Medicine in a statement. “It was striking to us how consistent our results were across healthcare centers and countries.”

Led by Schwenkglenks, the research team used PAIN OUT, an international acute pain registry and research project that collects patient-reported data (based on a standardized questionnaire) beginning the very first day after surgery. Across more than 40 health care centers in 15 countries, Schwenkglenks and his team used the PAIN OUT database to investigate levels of satisfaction for roughly 16,900 patients who had undergone a range of surgical procedures.

Surprisingly, the researchers found patients’ satisfaction with postoperative pain treatment is less about the intensity of pain than it is about their impressions of improvement and appropriateness of care. Specifically, becoming involved in the decision-making about their pain treatment seemed to be of high importance. Combining all the data from three continents and then crunching the numbers, the team concluded that three aspects were most important for patients: their pain experience, their involvement in the pain treatment process, and the nature of their relationship with their health care provider (for example, whether the doctor talked to them about all their treatment options).

Every year in the U.S., about 51.4 million surgeries are performed. The most common procedures include cesarean section (1.3 million), cardiac catheterizations (1.0 million), colonoscopies (about 1.6 million), hysterectomy (498,000), insertion of coronary artery stent (454,000), total knee replacement (719,000), and total hip replacement (332,000). Every operation causes some pain and management of that pain is a complex process. Generally, doctors attempt to tailor pain control to the needs of each individual patient. This means taking into account the age of the person and the procedure performed; their medical and physical condition; their level of anxiety; their response to different drugs; and finally their personal preference. Apparently, the more a doctor can involve the patient in this key decision, the better.

Source: Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, et al. Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry. PAIN. 2014.