title: Receipt of Pain Management Information Preoperatively Is Associated With Improved Functional Gain After Elective Total Joint Arthroplasty.
abstract: Poorly controlled postoperative pain may adversely affect total joint arthroplasty (TJA) patients' outcomes and associated healthcare cost. Understanding effective pain management after surgery is important to patients, surgeons, and hospitals. We evaluated patient-reported receipt of preoperative pain management information in a national prospective cohort evaluating postoperative pain and function following elective TJA.
  
  
  
  Preoperative and 2-week and 6-month postoperative survey data of 1609 TJA patients collected between June 2013 and December 2014 were analyzed. Data included demographics, medical and musculoskeletal comorbidity, operative joint pain, physical function, and mental health. At 2 weeks postoperative, patients were asked if they had received pain management information prior to surgery, the content of that education, and pain management strategies. Descriptive statistics were performed.
  
  
  
  At 2 weeks post-TJA, one-third of patients reported not receiving information about pain management; an additional 11% did not find the information helpful. There were no differences preoperatively in demographics or clinical profiles between those who received pain information and those who did not. Patients who received pain information reported less pain 2 weeks postoperatively, greater use of non-narcotic pain care strategies, and better physical function scores at 6 months postoperatively. No differences in operative joint pain were identified at 6 months between education and noneducation groups.
  
  
  
  Forty-four percent of the patients reported that they did not receive/received unhelpful information regarding postoperative pain management, highlighting a need for improved patient education. In this sample, the lack of pain management information was associated with poorer 6-month postoperative function.
authors.affiliation: Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Lemay
authors.affiliation: Department of Orthopaedic Surgery, Hartford Hospital, Hartford, Connecticut.
authors.forename: Courtland G
authors.initials: CG
authors.lastname: Lewis
authors.affiliation: Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.affiliation: Department of Orthopedics and Physical Rehabilitation, Clinical and Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Franklin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D059408:Pain Management; D010149:Postoperative Pain / Q000517:prevention & control*; D010353:Patient Education as Topic; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D011795:Surveys and Questionnaires
keywords: elective surgery; nonmedicine pain management; pain management education; patient-reported outcomes; total hip arthroplasty; total knee arthroplasty