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Assessment of chronic post-surgical pain after knee replacement : development of a core outcome set

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Wylde, V., MacKichan, F., Bruce, J. (Julie) and Gooberman-Hill, R. (2015) Assessment of chronic post-surgical pain after knee replacement : development of a core outcome set. European Journal of Pain, 19 (5). pp. 611-620. doi:10.1002/ejp.582

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Official URL: http://dx.doi.org/10.1002/ejp.582

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Abstract

Background
Approximately 20% of patients experience chronic post-surgical pain (CPSP) after total knee replacement (TKR). There is scope to improve assessment of CPSP after TKR, and this study aimed to develop a core outcome set.

Methods
Eighty patients and 43 clinicians were recruited into a three-round modified Delphi study. In Round 1, participants were presented with 56 pain features identified from a systematic review, structured interviews with patients and focus groups with clinicians. Participants assigned importance ratings, using a 1–9 scale, to individual pain features; those features rated as most important were retained in subsequent rounds. Consensus that a pain feature should be included in the core outcome set was defined as the feature having a rating of 7–9 by ≥70% of both panels (patients and clinicians) and 1–3 by ≤15% of both panels or rated as 7–9 by ≥90% of one panel.

Results
Round 1 was completed by 71 patients and 39 clinicians, and Round 3 by 62 patients and 33 clinicians. The final consensus was that 33 pain features were important. These were grouped into an 8-item core outcome set comprising: pain intensity, pain interference with daily living, pain and physical functioning, temporal aspects of pain, pain description, emotional aspects of pain, use of pain medication, and improvement and satisfaction with pain relief.

Conclusions
This core outcome set serves to guide assessment of CPSP after TKR. Consistency in assessment can promote standardized reporting and facilitate comparability between studies that address a common but understudied type of CPSP.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School
Journal or Publication Title: European Journal of Pain
Publisher: Elsevier Ltd.
ISSN: 1090-3801
Official Date: May 2015
Dates:
DateEvent
May 2015Published
25 August 2014Available
7 July 2014Accepted
Volume: 19
Number: 5
Page Range: pp. 611-620
DOI: 10.1002/ejp.582
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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