Patient Reported Outcome Measure (PROMs) assessment of day case pain control post breast surgery – new treatment pathway.

Abstract

Introduction

Day case surgery is an advancement in patient care and efficiency for hospitals.

The success of day surgery is dependent on the patient’s experience of the pathway including pain control.

Patient Reported Outcomes Measures (PROMs) validates the success of treatment and the quality of care delivered to NHS patients from the patient’s perspective.

Method

All patients undergoing day case breast surgery were assessed using PROMS to validate the surgical pathway with respect to pain control.

Patients were requested in advance to purchase simple over the counter analgesia to take according to their own requirements and hospital prescribed discharge analgesia was discontinued.

Results

Nearly all patients felt that their pain control immediately after surgery was good.

18.3% patients recorded that the pain kept them awake at night and 14.8% felt they needed stronger pain relief.

Importantly only 8.3% sought medical help post discharge and just 3.5% sought help from GPs for any reason.

Eight patients stayed overnight for medical reasons and stated that this was a necessary and acceptable outcome in the circumstances.

24.8% patients experienced some form of post operative issue.

Despite these experiences 95% stated they preferred having day case surgery.

Discussion

PROMS allows patient feedback of the treatment pathway and enables reflection and further improvement to be achieved.

The results support discontinuation of medication on discharge and patient self-medication with over-the-counter analgesia is an acceptable pathway. It does not result in a significant burden on GP or A+E with patients seeking pain relief from other sources.