评估骨科创伤患者术后疼痛治疗方案的患者理解与依从性调查。

Patient Comprehension and Compliance Survey to Assess Postoperative Pain Regimens in the Orthopaedic Trauma Population.

作者信息

Gangavalli Anup K, Malige Ajith, Rehman Saqib, Nwachuku Chinenye O

机构信息

*St. Luke's University Health Network, Bethlehem, PA;†Temple University/St. Luke's University School of Medicine, Bethlehem, PA; and‡Temple University Hospital, Philadelphia, PA.

出版信息

J Orthop Trauma. 2017 Jun;31(6):e190-e194. doi: 10.1097/BOT.0000000000000822.

DOI:10.1097/BOT.0000000000000822

PMID:28538459

Abstract

OBJECTIVE

This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen.

DESIGN

Survey-based cohort study.

SETTING

Suburban Level-I trauma center.

PATIENTS/PARTICIPANTS: A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist.

MAIN OUTCOME MEASUREMENTS

Patients who cannot accurately reproduce their prescribed pain medication list and patients who modify this pain medication regimen were analyzed by age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living.

RESULTS

Overall, 147 patients completed the survey. Seventy percent (n = 114) of patients could not accurately reproduce their pain medication regimen, regardless of age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living. Patients (61.2%; n = 90), regardless of the 6 aforementioned demographic factors, also admitted to modifying their pain medication regimen with non-prescribed medications, with 55.8% (n = 82) of patients adding over-the-counter medications to surgeon-prescribed narcotic medications.

CONCLUSIONS

Misunderstanding and noncompliance of surgeon-prescribed pain regimens are prevalent across all patient demographics. Knowledge of the potential effects these augmentative medications can have on fracture healing and any drug-drug interactions that may arise is an important aspect of patient postoperative care. Surgeons must be wary of these trends and screen for any unintended side effects a patient's pain regimen may have.

LEVEL OF EVIDENCE

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

摘要

目的

本研究旨在确定那些有不遵守和误解疼痛治疗方案风险的患者群体。

设计

基于调查的队列研究。

地点

郊区一级创伤中心。

患者/参与者：共有171名年龄在18 - 89岁之间的患者，他们接受了涉及骨盆、长骨或膝关节、踝关节、肘关节和腕关节周围区域骨折的手术固定。

主要观察指标

对不能准确复述其规定止痛药清单的患者以及修改该疼痛治疗方案的患者，按年龄、就业状况、收入水平、教育水平、手术与随访之间的时间以及疼痛是否干扰日常生活活动进行分析。

结果

总体而言，147名患者完成了调查。70%（n = 114）的患者不能准确复述其疼痛治疗方案，无论年龄、就业状况、收入水平、教育水平、手术与随访之间的时间以及疼痛是否干扰日常生活活动。无论上述6个人口统计学因素如何，患者（61.2%；n = 90）也承认用非处方药修改了他们的疼痛治疗方案，其中55.8%（n = 82）的患者在外科医生开的麻醉药中添加了非处方药。