Text message questionnaires for Patient-Reported Outcome Measures after Cesarean section-A feasibility study

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Digital Health

Background:

• Post-cesarean section pain significantly impacts recovery, with challenges in assessing pain, opioid use, and functional status post-discharge.
• Traditional assessment methods are difficult post-discharge, and Short Message Service (SMS) questionnaires offer a potential low-cost solution, though response rates can be a concern.

Purpose of the Study:

• To assess the feasibility of using SMS-based questionnaires for collecting detailed, prospective data on postoperative pain and recovery following cesarean section.
• To evaluate response rates and patient-reported outcomes including pain levels and opioid consumption.

Main Methods:

• A prospective, single-center cohort study included 100 patients undergoing elective cesarean sections under spinal anesthesia.
• Patients received SMS questionnaires at 6, 12, 18, 24, and 48 hours postoperatively, and on days 7 and 30.
• Standard postoperative pain management included paracetamol, NSAIDs, and oral morphine as needed.

Main Results:

• The study achieved a 78% response rate at 6 hours postoperatively, decreasing to 63% at 24 hours, with median response times under 25 minutes.
• 57% of patients reported severe pain (Numeric Rating Scale >6) at 6 hours, decreasing to 28% at 24 hours.
• Median opioid consumption in the first 24 hours was 30 mg.

Conclusions:

• SMS-based questionnaires are a feasible and cost-effective tool for prospectively gathering frequent Patient Reported Outcome Measures (PROMs) after cesarean section with acceptable response rates.
• Two-thirds of patients experienced severe pain within 24 hours post-cesarean, particularly in the initial 12 hours, indicating a need for optimized pain management strategies during this critical period.