The following is a summary of “Integration of Life Care Specialists Into Orthopaedic Trauma Care to Improve Postoperative Outcomes: A Pilot Study” published in the October 2022 issue of Pain Management by Giordano et al.
This pilot study aimed to determine if and how a Life Care Specialist (LCS) may improve orthopedic trauma care. At a level 1 trauma center, researchers conducted a prospective, single-group pilot trial to test the viability of a new treatment. The LCS is a paraprofessional behavior-based “pain coach” who coordinates care, educated patients about opioid safety, teaches them how to manage pain without drugs, and assessed patients’ risk for opioid addiction.
Pain was measured using a Numeric Rating Scale during admission, after discharge, and at the 2-week follow-up. Number of morphine milligram equivalents (MME) taken daily, number of opioid medications used at 2-week mark, and overall patient satisfaction were all noted. The average amount of morphine in MME was compared to the average amount of morphine given to the previous population of orthopaedic trauma patients using the T test. Pain ratings were analyzed longitudinally using generalized linear models. At the time of their first hospitalization, 22% of the 121 patients fulfilled criteria for moderate to severe risk of opioid misuse. Progressive muscle relaxation (used by 80% of participants) and sound therapy (48% of participants) were the most common LCS pain control strategies.
The average number of MMEs per day for inpatients was 40.5, which was considerably less than the average number of MMEs per day for the entire study period, which was 49.7 (P<.001). From the time of admission to 2 weeks after surgery, pain ratings decreased significantly (P<.001). Participants nearly unanimously (99%) found the LCS to be effective in controlling pain. The involvement and satisfaction of participants show that LCS can be successfully integrated into orthopedic trauma care, and the results also show that LCS can be used as valuable resources to aid in pain management and opioid education.
Source: sciencedirect.com/science/article/abs/pii/S152490422200100X
