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Implementation and evaluation of postoperative pain management protocols in older adults
Audrey Tabesse1, Claire Nicolle2, Anne-Lise Fiant2
1Department of Pharmacy, University Hospital of Caen Normandie, 14000, Caen, France.
Objectives:
To evaluate if the two new post-operative pain management protocols for older patients were well prescribed, administered, and monitored.
Methods:
A retrospective clinical audit of 100 older patients who were prescribed these protocols was conducted.
Results:
Only 17% of patients met all prescriptions criteria (age> 75 gt; 75 years, opioid naïve patient, recent surgery, no co-prescribing of inappropriate analgesics for older patients, no duplicate prescription and tramadol dosage following recommandations). Prescriptions issues were mostly inappropriate analgesic prescriptions (29%), duplicate medications (28%), and tramadol under-dosing (88%). None of the patients received 100% of the prescribed antalgics doses, administrations compliance was below 50%, only 8% for morphine. Pain was assessed rigorously (99%), monitoring for opioid-related side effects, like respiratory (6%) and vigilance (12%), was incomplete.
Conclusions:
This highlights challenges in implementing new postoperative analgesia protocols in a healthcare facility.
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