Around 3 out of 4 operations in the UK are performed as day-case, meaning the patient goes home on the same day of their operation. Hospitals usually do not follow up patients after day-case operations so we do not know very much about their short or long-term recovery. Some patients, even those who have had small operations, can develop persistent pain afterwards that continues for a long time (months to years). These patients may end up taking strong painkillers for a long time and this risks serious side effects and long-term health problems. The POPPY study aims to find out what recovery from day-case operations is like from the patient's point of view. We will look at the first week after patients' operations and then at 3 months to see if they are in pain, and if so what pain relief they are taking. All adults over the 5-day study period having day-case operations in the UK, with an anaesthetist, will be eligible if they have access to a smartphone. Patients will be recruited on the day of their operation from over 100 NHS hospitals. Some relevant information about the patient's current health, operation and anaesthetic will be recorded from their notes. Afterwards participants will get a text message at days 1, 3 and 7 and the at 3 months. These will connect to a data secure online questionnaire about pain, recovery, and what medications they are taking. A small number of participants with ongoing pain at 3 months will be invited to take part in a structured interview to understand their experience in more depth. This study will provide important information that may be used to improve care of patients having day-case operations and plan future research studies aimed to prevent persistent pain and long-term use of strong painkillers.
Study Type
OBSERVATIONAL
Enrollment
7,839
Operation, surgical group, magnitude of surgery, anaesthetic type.
University Hospitals Plymouth NHS Trust
Plymouth, Devon, United Kingdom
To measure short and long-term patient reported outcomes in UK day-case surgery patients.
See below outcomes for specifics (this is an overarching outcome which is broken down in the outcomes described below).
Time frame: 3 months
Short-term: to describe the quality of recovery over the first postoperative week
QOR-15 score (quality of recovery-15 score); BPI (brief pain inventory) derived pain scores; FPS (functional pain score)
Time frame: 1 week
Long-term: to establish the prevalence of persistent postsurgical pain (PPSP) and persistent postoperative opioid use (PPOU) in day case surgical patients.
PPOU prevalence (from medication use); pain at surgical site questionnaire; GAD-7 Score (generalised anxiety and depression 7 score); EQ-5D-5L score; BPI score; PHQ-8 Score (Patient Health Questionnaire 8)
Time frame: 3 months
To identify those patient, medication, anaesthetic, and surgical characteristics that are associated with poor quality of recovery, and PPSP and/or PPOU
Baseline data collection: age, sex, operation type, anaesthetic type, baseline medications and medication use on day 1, 3, 7 and 97 post-op. Medication use recorded as frequency of use and medication type.
Time frame: 3 months
To describe the acute pain experience and analgesia use in the first postoperative week
BPI (brief pain inventory) score on days 1, 3, 7; analgesia medication use on days 1, 3, 7
Time frame: 1 week
To estimate the need for further healthcare support in the first postoperative week
Yes/no question on questionnaire on day 7
Time frame: 1 week
To determine the patient reported acceptability of SMS prompted follow-up
Acceptability question on questionnaire on day 7
Time frame: 1 week
To determine the difference in quality of life between participants with and without PPSP
PHQ-8 Score; GAD-7 Score; EQ-5D-5L score at day 97
Time frame: 3 months
To investigate the difficulty in reducing opioid use in participants with PPOU
Yes/no question on questionnaire at day 97
Time frame: 3 months
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