Research help available to study pain

Web-based program provides tools, protocols

Between 50% and 80% of the 609 patients in a pain study conducted by the e-Pain Research Group in Montreal, had misconceptions about the pain they could expect after surgery and about the proper way to use medications to control pain.

Three of the six procedures studied were outpatient procedures: hernia repair, laparoscopic cholecystectomy, and knee arthroscopy. Patients who underwent these procedures also reported using herbs, acupuncture, massage, and physiotherapy to alleviate some of their pain.

The study was the first step in the development of the e-Pain Collaborative Network, a worldwide, web-based association of nurses, surgeons, and anesthesiologists who want to gain a better understanding of the pain levels in their own organization and protocols that can impact those levels.

"Our goal is to give surgery programs low-cost access to well-designed and structured protocols with pre-validated questionnaires that are ready to use," says Jennifer Cogan, MD, an anesthesiologist at the Montreal Heart Institute and one of the founders of the e-Pain Research Group. Not every surgical program has access to research resources that can develop tools that are needed to gather accurate data and compare that data with other organizations in order to benchmark progress, she says. "Our collaborative will not only allow participants to evaluate their own data, but also access the data collected across the network."

While the data collection tools and protocols used in the initial study were underwritten by grants, there will be a reasonable participation fee set to maintain the database on an ongoing basis, says Cogan. "I do not expect it to exceed $1,000 per year."

Other costs for participation are small

Other costs for participation are small, points out Ann Robinson, RN, CCRP, a research specialist at Boreal Primum, a health care research company based in Montreal. "Staff costs to conduct initial interviews and follow-up calls and to enter data are the primary costs," she says. A participant can choose from three levels of participation, she points out. Phase I measures postoperative pain levels on the day of surgery only. Phase II measures levels on the day of surgery and three months after surgery with questions related to quality of life and ability to handle activities of daily living. Phase III is the most comprehensive follow-up with information taken on the day of surgery, three months after surgery with questions about quality of life, and a description of medication or other pain control methods used, she says.

While collection of the data and comparison of data from organization to organization is beneficial to participants, e-Pain network members also will be expected to share their research findings through publication in clinical journals, says Robinson. "The best way for us to improve our understanding of postoperative pain is to share the data," she says. Because many clinicians outside the academic arena don’t understand the process for publication, e-Pain network members will have access to people who can guide them through the process, she explains.

All of the data collection tools and protocols will be available on the web site (www.borealprimum.com), says Robinson. Data will be collected and evaluated through the same web site, she adds.

Pain is hard to evaluate, because it is different for each patient, Robinson admits. "We also see that some patients expect pain, so they don’t let us know about it because they don’t want to complain," she says. Studies conducted through the e-Pain network will enable clinicians to develop better treatment protocols and better patient education so that patients will know what may be normal, she adds.

With pain management becoming the focus of many organizations’ improvement efforts, this is a good time for an association to research pain, says Robinson. "There have been so many options for pain control developed that it is important that we evaluate their use and find ways to prevent acute post-surgical pain from becoming chronic pain."

Sources

For more information about the e-Pain Collaborative Network, contact:

  • Jennifer Cogan, MD, Anesthesiologist, Montreal Heart Institute, Quebec, Canada. Telephone: (514) 376-3330, ext. 3811. E-mail: jennifer.cogan@mcgill.ca.
  • Ann Robinson, RN, CCRP, Research Specialist, Boreal Primum, 913 Cherrier, Montreal, Quebec, Canada H2L 1J1. Telephone: (514) 596-1522. Fax: (514) 596-1897. E-mail: a.robinson@borealprimum.com.