PMID- 35177930
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220501
IS  - 1178-7090 (Print)
IS  - 1178-7090 (Electronic)
IS  - 1178-7090 (Linking)
VI  - 15
DP  - 2022
TI  - Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a 
      View to Optimizing Practices.
PG  - 385-402
LID - 10.2147/JPR.S342627 [doi]
AB  - PURPOSE: To examine 1) pain management strategies within the care trajectory of 
      orthopaedic trauma patients and patients' perception of their effectiveness, 2) 
      adverse effects (AEs) associated with pharmacological treatments, particularly 
      opioids and cannabis, and 3) patients' perceptions of strategies that should be 
      applied after an orthopaedic trauma and support that they should obtain from 
      health professionals for their use. PATIENTS AND METHODS: This study was 
      conducted with orthopaedic trauma patients in a level 1 trauma center. A 
      convergent mixed-methods design was used. Data on pain experience, pain 
      management strategies used and AEs were collected with self-administered 
      questionnaires at hospital discharge (T1) and at 3 months after injury (T2). 
      Patients' preferences about the pain management strategies used, the required 
      support and AEs were further examined through semi-structured individual 
      interviews at the same time measures. Descriptive statistics and thematic 
      analyses were performed. RESULTS: Seventy-one patients were recruited and 30 
      individual interviews were undertaken. Pharmacological pain management strategies 
      used at T1 and T2 were mainly opioids (95.8%; 20.8%) and acetaminophen (91.5%; 
      37.5%). The most frequently applied non-pharmacological strategies were sleep 
      (95.6%) and physical positioning (89.7%) at T1 and massage (46.3%) and relaxation 
      (32.5%) at T2. Findings from quantitative and qualitative analyses highlighted 
      that non-pharmacological strategies, such as comfort, massage, distraction, and 
      physical therapy, were perceived as the most effective by participants. Most 
      common AEs related to opioids were dry mouth (78.8%) and fatigue (66.1%) at T1 
      and insomnia (30.0%) and fatigue (20.0%) at T2. Dry mouth (28.6%) and drowsiness 
      (14.3%) were the most reported AEs by patients using recreational cannabis. An 
      important need for information at hospital discharge and for a personalized 
      follow-up was identified by participants during interviews. CONCLUSION: Despite 
      its AEs, we found that opioids are still the leading pain management strategy 
      after an orthopaedic trauma and that more efforts are needed to implement 
      non-pharmacological strategies. Cannabis was taken for recreational purposes but 
      patients also used it for pain relief. Support from health professionals is 
      needed to promote the adequate use of these strategies.
CI  - (c) 2022 Grzelak et al.
FAU - Grzelak, Sonia
AU  - Grzelak S
AD  - Population Health and Optimal Practices Research Unit (Trauma - Emergency - 
      Critical Care Medicine), Laval University Research Center (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
AD  - Faculty of Nursing, Laval University, Quebec City, QC, Canada.
FAU - Berube, Melanie
AU  - Berube M
AUID- ORCID: 0000-0002-6657-3915
AD  - Population Health and Optimal Practices Research Unit (Trauma - Emergency - 
      Critical Care Medicine), Laval University Research Center (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
AD  - Faculty of Nursing, Laval University, Quebec City, QC, Canada.
FAU - Gagnon, Marc-Aurele
AU  - Gagnon MA
AD  - Population Health and Optimal Practices Research Unit (Trauma - Emergency - 
      Critical Care Medicine), Laval University Research Center (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
FAU - Cote, Caroline
AU  - Cote C
AUID- ORCID: 0000-0003-2097-8738
AD  - Population Health and Optimal Practices Research Unit (Trauma - Emergency - 
      Critical Care Medicine), Laval University Research Center (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
AD  - Faculty of Nursing, Laval University, Quebec City, QC, Canada.
FAU - Turcotte, Valerie
AU  - Turcotte V
AD  - Nursing Department, CIUSSS du Nord-de-l'Ile-de-Montreal, Hopital du Sacre-Coeur 
      de Montreal, Montreal, QC, Canada.
FAU - Pelet, Stephane
AU  - Pelet S
AD  - Department of Orthopedic Surgery, CHU de Quebec-Universite Laval (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
FAU - Belzile, Etienne
AU  - Belzile E
AD  - Department of Orthopedic Surgery, CHU de Quebec-Universite Laval (Hopital de 
      l'Enfant-Jesus), Quebec City, QC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20220209
PL  - New Zealand
TA  - J Pain Res
JT  - Journal of pain research
JID - 101540514
PMC - PMC8843780
OTO - NOTNLM
OT  - cannabis
OT  - non-pharmacological strategies
OT  - opioids
OT  - orthopaedic trauma
OT  - pain
OT  - pharmacological strategies
COIS- Dr Stephane Pelet reports grants from CIHR, grants from MSSS, grants from CRSH, 
      outside the submitted work. Dr Etienne Belzile reports grants from CIHR, grants, 
      personal fees from Stryker, grants, personal fees from DePuy Synthese, grants, 
      personal fees from BodyCad, personal fees from Pendopharm, personal fees from 
      Conmed, outside the submitted work. Melanie Berube received research salary award 
      from FRQS and SPOR - Quebec. The authors report no other conflicts of interest in 
      this work.
EDAT- 2022/02/19 06:00
MHDA- 2022/02/19 06:01
PMCR- 2022/02/09
CRDT- 2022/02/18 05:46
PHST- 2021/10/04 00:00 [received]
PHST- 2022/01/14 00:00 [accepted]
PHST- 2022/02/18 05:46 [entrez]
PHST- 2022/02/19 06:00 [pubmed]
PHST- 2022/02/19 06:01 [medline]
PHST- 2022/02/09 00:00 [pmc-release]
AID - 342627 [pii]
AID - 10.2147/JPR.S342627 [doi]
PST - epublish
SO  - J Pain Res. 2022 Feb 9;15:385-402. doi: 10.2147/JPR.S342627. eCollection 2022.