Article Text
Abstract
Background and Importance The prevalence of pain in post-operative patients is 88.2%, with moderate to severe pain in 19.6% of cases.
Aim and Objectives The objective was to describe pharmaceutical interventions in pain management and the impact on patient-reported pain on admission and discharge and patient satisfaction.
Material and Methods A prospective interventional study (March-May 2023) in hospitalised adult patients admitted in general or trauma surgery was carried out.
Outcome measures patient-perceived pain (VAS) and patient satisfaction.
Pharmaceutical interventions were made 48 and 96 hours after surgery (at bedside) and 48 hours after discharge (by telephone):
1. Admission:
1.1. Reminding nurses of recording VAS (one per nursing shift).
1.2. If VAS≥4, interventions in analgesia prescription and/or in nurse’s administration
1.3 Patient education on VAS scale, therapeutic options and the importance of asking for analgesia if pain.
2. Discharge:
2.1. If VAS>2 patients were reminded how to take analgesia. If no analgesia prescribed, the patient was referred to a primary care physician (PCP).
2.2. If they took the prescribed medication and VAS=4–6, they were referred to PCP and if VAS≥7, to the emergency department.
A descriptive analysis was used.
Results Sixty patients were included, mean age of 66.7 (±16.4) years
On admission, 94 interventions were made (92.3% accepted): to encourage VAS recording (n=26), administer analgesia (n=18), prescribe analgesia (n=18), increase therapeutic step (n=17) and patient education (n=15).
An increase in VAS recording was observed (56.7% vs 76.3%). There was a progressive decrease in current patient-reported pain (2.1 vs 1.9 vs 1.4) and maximum pain in last 24 hours (3.2 vs 2.7 vs 2.3) and in the number of patients with VAS ≥4.
At discharge, 39 interventions were performed: 23 patients were reminded how to take the prescribed analgesia, 15 were referred to PCP for lack of analgesia prescription or moderate pain, and one was referred to the emergency department.
Satisfaction with postoperative pain management and the pharmaceutical care was 7.9 (±2.1) and 9.7(±0.5), respectively.
Conclusion and Relevance Pharmaceutical interventions on education, recording, administration and prescription of analgesics might have contributed to a gradual reduction in patient-reported pain. The pharmacist plays a role in the management of postoperative pain during admission and at discharge with high patient satisfaction.
Conflict of Interest No conflict of interest.