Inclusion of a life care specialist may reduce pain after orthopedic trauma surgery
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Key takeaways:
- Patients who worked with a life care specialist had 2.8 higher odds of improved pain.
- Pain scores improved by two or more points in 90% of patients who worked with a life care specialist.
SEATTLE — Patients who worked with a life care specialist after orthopedic trauma injury may experience improved pain outcomes at 3 months postoperatively, according to results presented here.
Jesse Seilern und Aspang, MD, and colleagues randomly assigned 129 patients with an orthopedic trauma injury admitted to a level-1 trauma center to receive a standardized pain protocol either with (n=72) or without (n=57) working with a life care specialist.
“What the life care specialist looks like currently is a pain coach that visits the patient as an outpatient and follows them for the duration of the study,” Seilern und Aspang said in his presentation at the Orthopaedic Trauma Association Annual Meeting. “They apply certain nonpharmacological modalities, including meditation, pain medication education and, among others, music therapy and sleep therapy. They also work as care coordinators and sometimes advocates for patients when it comes to referrals to the community or suggestions for the primary care team.”
Researchers collected numeric rating scale pain scores at baseline and at 6 and 12 weeks postoperatively, as well as Patient-Reported Outcome Measurement Information System (PROMIS) measures and opioid utilization in morphine milligram equivalents.
Seilern und Aspang said patients who worked with a life care specialist experienced greater improvements in pain intensity, with a 2.8 higher odds of reporting improved pain at 3 months postoperatively. He added 90% of patients who worked with a life care specialist had an improved pain score by two or more points, achieving the minimal clinically important difference.
“Looking at PROMIS scores, there were no obvious differences in functional outcomes or self-reported indicators of misuse at 3 months, and milligram morphine equivalents were lower in the intervention group; however, [this was] not statistically significant when it came to discharge opioids,” Seilern und Aspang said.
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Seilern und Aspang J, et al. Paper 123. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 18-21, 2023; Seattle.
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