Patients involved with pain treatment report higher levels of satisfaction

An international study on patient satisfaction with pain treatment after surgery shows that patients who are actively involved in their treatment report higher levels of satisfaction. Overall, satisfaction seems to be less associated with actual pain but rather with impressions of improvement.

An international research group that included members from the University of Basel, several EU countries, Israel and the USA, based its survey on an extensive multi-national dataset and the results have been published in Pain [Schwenkglenks et al. (2014) Pain 155, DOI: 10.1016/j.pain.2014.04.021].

Well-managed postoperative pain is an important quality criterion for healthcare providers. Even though previous studies have shown that patient ratings of satisfaction with their pain treatment tend to be high, the determinants for this effect are poorly understood and have previously not been studied using large-scale, international datasets.

The research team led by Matthias Schwenkglenks from the Institute of Pharmaceutical Medicine used PAIN OUT, an EUfunded, international acute pain registry that collects patient reported outcome data on day one after surgery. Patients use a standardised questionnaire for self-completion.

Schwenkglenks and co-workers used the PAIN OUT database to investigate patient satisfaction levels across more than 40 healthcare centres in 15 countries. The study included around 17,000 patients who had undergone a wide range of surgical procedures.

The analysis showed three aspects to be most important for patient satisfaction: pain experience, patient involvement and characteristics of the patient–caregiver relationship (e.g. provision of adequate information on pain treatment options).

“We were the first research group that was able to study this topic at such a large scale, a unique opportunity. It was striking to us how consistent our results were across healthcare centres and countries,” said Schwenkglenks.

Overall, the findings indicated that satisfaction with postoperative pain treatment is less associated with the patients’ actual pain experience but rather with impressions of improvement and appropriateness of care. Specifically, the patient’s involvement in the decision-making process seems to be of high importance. The study thus suggests that in the effort to manage pain effectively, it would be inappropriate to focus on low pain intensity as the only goal of postoperative pain treatment. Patients should, to the degree they desire, be provided with information and be involved in pain treatment decisions.

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