Patient Satisfaction Following Spine Surgery is Not Associated with Greater Opioid Use

Neither increased opioid consumption nor use of non-opioid pain medications following spinal surgery were significantly associated with patient-reported satisfaction with pain control or hospitalization in a single-center retrospective analysis presented at the 31st Annual Meeting of the North American Spine Society in Boston, MA.

“Overall satisfaction with pain control and the efforts of the staff to focus on the pain were associated with hospital satisfaction,” said coauthor W. Ryan Spiker, MD, who is Assistant Professor in the Department of Orthopaedic Surgery at the University of Utah in Salt Lake City.
Pain scores were significantly associated with satisfaction with pain control, but interestingly were not associated with overall hospital stay.The study involved all patients (n=312; average age, 61 years; 50% female) who underwent spinal surgery at a single tertiary care center and completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and a numerical pain rating scale between December 2010 and March 2014. The most common procedures were lumbar and anterior cervical spinal surgery.

Half of Patients’ Pain Was “Always” Controlled
The average pain score in this group was 3. Approximately 50% of patients reported that their pain was “always” controlled and nearly 75% were “satisfied” with their hospitalization based on HCAHPS survey responses (ie, 9 or 10 ranking on a 10-point scale).

“Patients were significantly more likely to be satisfied with pain control with less opioid usage, than if they had more opioid usage,” Dr. Spiker said. “A similar trend was found with satisfaction with overall hospital stay, but this association did not reach statistical significance.”

No correlation was found between use of non-opioid pain medication and satisfaction with pain control or overall hospital stay.

Pain Scores Were Not Linked to Satisfaction with Hospital Stay
As expected, pain scores were significantly associated with satisfaction with pain control, but interestingly were not associated with overall hospital stay.

Patients who reported that their pain was “always” controlled were more satisfied with their hospitalization, and patients reporting that the hospital staff always did everything they could to provide pain control was significantly associated with hospital satisfaction.

“Certainly, pain is an important issue, but the actual values of that pain may not be as important as we previously thought,” Dr. Spiker said. “The take-home message from this study is that, certainly, communication of pain and the patient’s experience of pain are important contributors to patient satisfaction with care, but narcotics may not be the answer.”

 Study limitations included the retrospective single-center design, a potential survey response bias, and that pain scores were taken at different times of the day, including before and after physical therapy or when pain medications were given.

To view additional meeting highlights from the 31^st Annual Meeting of NASS, click here.