Patient Preferences for Pain Control After Mohs Micrographic Surgery: A Single-Center Discrete Choice Experiment.

Area of Science:

• Dermatology and Plastic Surgery
• Pain Management and Pharmacology
• Patient-Reported Outcomes

Background:

• Understanding patient preferences for pain management after Mohs micrographic surgery is crucial but understudied.
• Patient choices are influenced by pain levels and perceived risks of opioid addiction.

Purpose of the Study:

• To evaluate patient preferences for pain management using only over-the-counter (OTC) medications versus OTCs plus opioids.
• To assess these preferences across varying theoretical pain levels and opioid addiction risks.

Main Methods:

• A prospective discrete choice experiment was conducted with 295 patients and support persons.
• Participants completed a survey assessing pain medication preferences under different scenarios of pain and addiction risk.
• Data were analyzed using linear interpolation to determine pain thresholds for medication choices.

Main Results:

• 76% of respondents preferred only OTCs over OTCs plus opioids for post-Mohs surgery pain control.
• 34% would never consider opioids, and 50% worried about addiction.
• Only when addiction risk was 0% did half prefer opioids at a pain level of 6.5/10; higher risks led to a preference for OTCs only, even with severe pain.

Conclusions:

• Perceived risk of opioid addiction significantly influences patient choices for pain medication after Mohs surgery.
• Shared decision-making is essential for tailoring pain management plans to individual patient needs and concerns.
• Further research into long-term opioid risks post-Mohs surgery is warranted.