title: Acute postoperative pain following hospital discharge after total knee arthroplasty.
abstract: OBJECTIVE
  The increasingly shorter hospitalization following total knee arthroplasty (TKA) requires patients to assume earlier responsibility to self-manage their pain. Poorly managed acute pain increases the risk of persistent pain, reduces quality of life and increases unnecessary healthcare utilization. This study aims to examine post-discharge pain intensity, pain management behaviors and potential barriers to optimal self-management of pain.
  
  
  METHODS
  We administered a questionnaire at 2 weeks after discharge to 174 patients undergoing TKA in 10 Australian hospitals. Participants rated pain expectation and severity, use of analgesics and non-pharmacological methods, side-effects, walking and exercise times, perceptions of analgesics, adequacy of pain management information provided and satisfaction with pain relief.
  
  
  RESULTS
  Of 171 (98%) participants who completed the questionnaire, 88 (52%) reported that the worst pain period occurred during the first 2 weeks at home. During the first 2 weeks at home, the average pain was 'severe/extreme' for 40 (23%) participants and 92 (54%) experienced severe pain at least some of the time. Many participants sought further medical help for their pain. Adequate information on analgesics and non-pharmacological methods for pain relief were reported by only 73% and 47%, respectively. Approximately 20% had negative perceptions about analgesic use. Higher pain severity was associated with lower satisfaction and less time spent walking daily.
  
  
  CONCLUSIONS
  Effective pain relief after hospital discharge following TKA is a challenge. Many participants reported significant pain, sought further medical help for pain relief and had inadequate information at discharge to effectively self-manage their postoperative knee pain.
authors: Faculty of Health Sciences, University of Sydney, NSW, Australia. eeyuee@gmail.com
authors: E Y
authors: EY
authors: Chan
authors: F M
authors: FM
authors: Blyth
authors: L
authors: L
authors: Nairn
authors: M
authors: M
authors: Fransen
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000601:surgery*; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D010351:Patient Discharge; D017060:Patient Satisfaction; D012307:Risk Factors; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics
keywords: Acute pain; Analgesics; Knee arthroplasty; Non-pharmacological methods; Pain management; Surveys