Real world patient-reported and health care professional-perceived pain severity in outpatient fracture clinic procedures

Abstract

Introduction: Management of orthopaedic fractures involves acute intervention and follow up through to recovery. Patient-centered care needs to encompass all aspects of this treatment. Limited research is available on outpatient satisfaction and patient-reported outcomes from fracture clinic (FRCL). The purpose of this evaluation is to report on pain levels perceived by patients from minor orthopaedic procedures that were necessary for the continued management of fracture care. Methods: Patients were recruited in the FRCL if they were planned to undergo minor orthopaedic procedures. They were asked to report the pain they experienced at baseline, during the procedure, 20 min post-procedure, and 24 h following the procedure on a verbal numeric rating scale of 0–10. Healthcare professionals (HCP) were then asked to rank their perception of the severity of pain from each procedure type. Finally, qualitative interviews were conducted on a convenience sample of patients. Results: 51 patients were included in this evaluation. Halo pin, external fixation device, Kirschner wire, and screw removal exhibited a mean increase in pain from baseline greater than 3 units during the procedure. The external fixation device removal group showed the greatest pain reported with a statistically significant increase from baseline to the end of the procedure (mean = 7.1; p = 0.002). There was good concordance of pain perception by the HCP to patient experience. Qualitative interviewing revealed two major themes. Discussion: This study provided valuable qualitative and quantitative insight into the pain perceptions by FRCL patients. This data may help improve the patient experience inside the FRCL.