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A follow-up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF
Yannick Walrave1, Michel Carles2, Jean-Noel Evain3
1Department of Pediatric Anaesthesia and Intensive Care, Clinique Saint George, Nice, France.
Insights
A smartphone app effectively tracked pediatric postoperative pain, showing satisfactory pain management in families using the tool. Further research should explore live data collection for improved patient-physician communication.
Area of Science:
- Pediatric surgery
- Pain management
- Digital health
Background:
- Postoperative pain is a common issue in pediatric patients.
- Effective pain assessment is crucial for optimal recovery.
- Smartphone applications offer a novel approach to data collection.
Purpose of the Study:
- To evaluate a smartphone application for assessing pain duration and severity in children after outpatient surgery.
- To analyze factors influencing postoperative pain and parent satisfaction.
- To explore the utility of app-based data collection in pediatric pain management.
Main Methods:
- A French multicenter epidemiological study (AlgoDARPEF) involving children under 18 undergoing outpatient surgery.
- Parents used a smartphone app (Parents' Postoperative Pain Measure-Short-Form) for daily pain and comfort reporting.
- Children over 6 years could self-assess pain using a numerical rating scale (NRS)-11.
Main Results:
- 49% of parents used the app; average pain ratings remained below 3/10.
- Age, visceral surgery, and preoperative anxiety were risk factors for significant postoperative pain.
- App usage indicated satisfactory pain management, with a suggestion for improved anxiety control.
Conclusions:
- Smartphone apps can provide valuable insights into pediatric postoperative pain and recovery.
- Continuous app-based reporting facilitates assessment of pain and adverse events.
- Future studies should focus on live data collection via apps for efficient patient-physician interaction.
Abstract:
In pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children younger than 18 years scheduled for an elective outpatient procedure in one of the participating centers were eligible. Parents were invited to provide daily information for 10 days regarding their child's pain and comfort through a smartphone App using the Parents' Postoperative Pain Measure-Short-Form (PPPM-SF). Children older than 6 years could also provide self-assessments of pain using a numerical rating scale (NRS)-11. Data regarding pain medication, preoperative anxiety, postoperative nausea and vomiting, and parent satisfaction were also analyzed. Repeated-measures analyses of variances (ANOVAs) were used to compare the self-assessments and hetero-assessments of pain. Eleven centers participated in the study, and 1573 patients were recruited. Forty-nine percentage of parents (n = 772) actually used the App at least once. In all surgeries, the average pain rating on the PPPM-SF scale did not exceed 3/10 throughout the follow-up period, as well as for 4 main surgical specialties. Age, visceral surgery, and preoperative anxiety ≥ 4/10 were identified as independent risk factors for experiencing at least 1 episode of pain ≥4/10 during the first 48 postoperative hours. Although these findings indicated that postoperative pain management seems to be satisfactory in the families who used the App, some improvements in anxiety management are suggested. This study shows that inviting parents to use a smartphone App to assess and report the quality of postoperative management in pediatric patients provides useful information. A continuous report regarding pain and adverse events over a 10-day postoperative period by a self-reporting or parent's contribution is possible. Future studies should investigate the ability of live data collection using an App to ensure fast, efficient interactions between patients and physicians.
