Evidence map›Paper›PMID 39237920›Full record

ArticleBMC geriatrics2024

Perioperative pain management intervention in older patients with hip fracture in an orthogeriatric unit. A controlled before/after study assessing an audit and feedback intervention (PAIN-AGE).

Sabine Drevet, Bastien Boussat, Armance Grevy, Audrey Brevet, Frederic Olive, Marion Richard, Laura Marchesi, Alize Guyomard, Caroline Maindet, Regis Pailhe and 7 more

Abstract read
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Sabine DrevetUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France. SDrevet@chu-grenoble.fr.
Bastien BoussatUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Clinical Epidemiology and Medical Evaluation - Quality of Care Unit, Grenoble, France.
Armance GrevyUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Geriatric Department, Grenoble, France.
Audrey BrevetUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France.
Frederic OliveUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Public Health Department, Grenoble, France.
Marion RichardUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Anesthesiology Department, Grenoble, France.
Laura MarchesiUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France.
Alize GuyomardUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Clinical Epidemiology and Medical Evaluation - Quality of Care Unit, Grenoble, France.
Caroline MaindetCenter for Pain Treatment, University Hospital Grenoble Alpes, Grenoble, France.
Regis PailheUniv. Grenoble Alpes, University Hospital Grenoble Alpes Southern Site, Orthopaedic and Traumatology Surgery Department, Grenoble, France.
Brice Rubens-DuvalUniv. Grenoble Alpes, University Hospital Grenoble Alpes Southern Site, Orthopaedic and Traumatology Surgery Department, Grenoble, France.
Pierre BouzatUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Anesthesiology Department, Grenoble, France.
Jérôme TonettiUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France.
Catherine BioteauUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France.
Gaëtan GavazziUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Orthogeriatric Unit, Orthopaedic and Traumatology Surgery Department , Grenoble, France.
Patrice FrancoisUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Clinical Epidemiology and Medical Evaluation - Quality of Care Unit, Grenoble, France.
Prudence GibertUniv. Grenoble Alpes, University Hospital Grenoble Alpes, Geriatric Department, Grenoble, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative pain delays ambulation, extends hospital stay, reduces the probability of recovery, and increases risk of long-term functional impairment. Pain management in hip fractured patients poses a challenge to the healthcare teams. Older adults are more vulnerable to opioid-associated side effect and it is primordial to minimize their exposure to opioids. Acetaminophen is associated with reduced opioid use so we need to focus on acetaminophen use in first-line analgesia.

methodsWe conducted a controlled before/after study to assess the ability of an audit and feedback (A&F) intervention built with nurses to improve the quality of perioperative pain management in older patients hospitalized for hip fracture in an orthogeriatric unit (experimental group) versus a conventional orthopedic unit (no A&F intervention). The primary endpoint was the percentage of patients who received 3 g/day of acetaminophen during the three postoperative days, before and after the A&F intervention. Secondary endpoints included nurses' adherence to medical prescriptions, clinical data associated with patients and finally factors associated with intervention. The significative level was set at 0.05 for statistical analysis.

resultsWe studied data from 397 patients (mean age 89 years, 75% female). During the postoperative period, 16% of patients from the experimental group received 3 g/day of acetaminophen before the A&F intervention; the percentage reached 60% after the intervention. The likelihood of receiving 3 g/day of acetaminophen during the postoperative period and adhering to the medical prescription of acetaminophen were significantly increased in the experimental group as compared with the control group. The patient's functional status at discharge (assessed by Activities of Daily Living scores) was significantly better and the length of hospital stay significantly reduced after the A&F intervention.

conclusionOur controlled before/after study showed that an A&F intervention significantly improved perioperative pain management in older adults hospitalized for hip fracture. Involving teams in continuous education programs appears crucial to improve the quality of pain management and ensure nurses' adherence to medical prescriptions.

Indexed as

Controlled Before-After StudiesHip FracturesPain ManagementPostoperative PainAcetaminophenAgedAged, 80 and overAnalgesics, Non-NarcoticFemaleHospital UnitsHumansMaleMedical AuditPain MeasurementPerioperative CareAcetaminophenAnalgesics, Non-NarcoticAcetaminophenAdherenceEducationHip fracturesInterventionNursesPainPerioperative periodProgram

Identifiers

PMID39237920
PMCPMC11375881

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.