1 Department of Orthopedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , Iowa City, Iowa.
2 Division of Orthopedic Surgery, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
Telemed J E Health. 2018 Jul;24(7):504-509. doi: 10.1089/tmj.2017.0188. Epub 2017 Dec 20.
Communication with orthopedic trauma patients is traditionally problematic with low response rates (RRs). The purpose of this investigation was to (1) evaluate the feasibility of communicating with orthopedic trauma patients postoperatively, utilizing an automated mobile phone messaging platform; and (2) assess the first 2 weeks of postoperative patient-reported pain and opioid use after lower extremity orthopedic trauma procedures.
This was a prospective investigation at a Level 1 trauma center in the United States. Adult patients who were capable of mobile phone messaging and were undergoing common, lower extremity orthopedic trauma procedures were enrolled in the study. Patients received a daily mobile phone message protocol inquiring about their current pain level and amount of opioid medication they had taken in the past 24 h starting on postoperative day (POD) 3 and continuing through POD 17. Our analysis considered (1) Patient completion rate of mobile phone questions, (2) Patient-reported pain level (0-10 scale), and (3) Number and percentage of daily prescribed opioid medication patients reported taking.
Twenty-five patients were enrolled in this investigation. Patients responded to 87.5% of the pain and opioid medication inquiries they received over the 2-week study period. There were no differences in RRs by patient age, sex, or educational attainment. Patient-reported pain decreased over the initial 2-week study period from an average of 4.9 ± 1.7 on POD 3 to 3 ± 2.2 on POD 16-17. Patients took an average of 68% of their maximum daily narcotic prescription on POD 3 compared with 35% of their prescribed pain medication on POD 16-17.
We found that in orthopedic trauma patients, an automated mobile phone messaging platform elicited a high patient RR that improved upon prior methods in the literature. This method may be used to reliably obtain pain and medication utilization data after trauma procedures.
与骨科创伤患者的沟通传统上存在问题，响应率（RR）较低。本研究的目的是：（1）评估利用自动手机短信平台与骨科创伤患者术后沟通的可行性；（2）评估下肢骨科创伤手术后患者术后前 2 周的疼痛和阿片类药物使用情况。
这是美国一家 1 级创伤中心的前瞻性研究。纳入有能力进行手机短信并接受常见下肢骨科创伤手术的成年患者。患者在术后第 3 天（POD）开始接受每天的手机短信询问，询问他们目前的疼痛程度以及过去 24 小时内服用的阿片类药物量，一直持续到 POD17。我们的分析考虑了（1）患者完成手机问题的比例；（2）患者报告的疼痛程度（0-10 分）；（3）患者报告的每日规定阿片类药物用量及百分比。
本研究共纳入 25 例患者。在为期 2 周的研究期间，患者对收到的 87.5%的疼痛和阿片类药物询问做出了回应。患者的 RR 与年龄、性别或受教育程度无关。在最初的 2 周研究期间，患者报告的疼痛从 POD3 的平均 4.9±1.7 降至 POD16-17 的 3±2.2。患者在 POD3 时平均服用了其最大日剂量麻醉处方的 68%，而在 POD16-17 时平均服用了其规定止痛药物的 35%。
我们发现，在骨科创伤患者中，自动手机短信平台引起了较高的患者 RR，优于文献中的先前方法。这种方法可用于可靠地获取创伤手术后的疼痛和药物使用数据。
