兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Healthcare delivery gaps in pain management within the first 3 months after discharge from inpatient noncardiac surgeries: a scoping review.

2023-01-01

Background: Poor pain control during the postoperative period has negative implications for recovery, and is a critical risk factor for development of persistent postsurgical pain. The aim of this scoping review is to identify gaps in healthcare delivery that patients undergoing inpatient noncardiac surgeries experience in pain management while recovering at home. Methods: Searches were conducted by a medical librarian in PubMed, MEDLINE, EMBASE, EBSCO CINAHL, Web of Science, and Cochrane Database of Systematic Reviews for articles published between 2016 and 2022. Inclusion criteria were adults (≥18 yr), English language, inpatient noncardiac surgery, and included at least one gap in care for acute and/or persistent pain management after surgery within the first 3 months of recovery at home. Two reviewers independently screened articles for inclusion and extracted data. Quotations from each article related to gaps in care were synthesised using thematic analysis. Results: There were 4794 results from databases and grey literature, of which 38 articles met inclusion criteria. From these, 23 gaps were extracted, encompassing all six domains of healthcare delivery (capacity, organisational structure, finances, patients, care processes and infrastructure, and culture). Identified gaps were synthesised into five overarching themes: education (22 studies), provision of continuity of care (21 studies), individualised management (10 studies), support for specific populations (11 studies), and research and knowledge translation (10 studies). Conclusions: This scoping review identified health delivery gaps during a critical period in postoperative pain management. These gaps represent potential targets for quality improvement and future research to improve perioperative care and longer-term patient-centred outcomes. Scoping review protocol: Open Science Framework (https://osf.io/cq5m6/)
   

研究类型
系统评价再评价
人群
成年人
主题
医疗护理
国家
Canada
关键词
gaps in care; health delivery; pain management; persistent postsurgical pain; post-discharge; postoperative pain; transitional pain service.
来源期刊
Br J Anaesth
发布日期
2023-01-01
全文链接
https://pubmed.ncbi.nlm.nih.gov/37716887/
相关网址
https://pubmed.ncbi.nlm.nih.gov/37716887/
DOI
10.1016/j.bja.2023.08.006
作者
Lindsay Blake Janny X C Ke Heather Stuart Maya de Vos Alana Flexman Jason Park Katarina Kojic Daniel I McIsaac Mark Hwang Jill Osborn