Introduction:
Locally, day surgery patients receive approximately one-weeks supply of discharge medications. With GP collective action it has proved difficult for patients to access additional pain relief after this time leading to the potential for unmanaged pain and strain on healthcare resources. We realised that we needed a more responsive approach and designed a "just-in-case" prescription system.
Method:
A quality improvement initiative was undertaken to:
- facilitate access to additional pain relief without additional healthcare visits.
- rationalise analgesic use, particularly opiates, by dispensing based on
patient need.
Patients could access two prescriptions:
- Immediate post-operative analgesia dispensed as per usual clinical guidelines
- ‘Just-in-Case’ Analgesia stored in the hospital pharmacy and dispensed only upon patient request after their initial supply was exhausted.
Results
During the pilot, 365 discharge prescriptions were reviewed.
- Six patients (1.6%) required ‘just-in-case’ analgesia
- The average time to request was 3 ± 1 day’s post-surgery.
- All patients reported extreme satisfaction, citing improved pain control, reduced stress, and increased confidence in their recovery process.
No patients reported difficulties in accessing the reserve medications.
Conclusion
This pilot demonstrated the feasibility and potential benefits of a system to enhance post-operative pain management. Although only a small percentage of patients utilised the prescriptions, their high satisfaction levels support the hypothesis that this system addresses a critical gap in patient care, contributing to a reduction in visits to GP practices, emergency departments, and community pharmacies. This aligns with existing literature highlighting the importance of patient centred discharge planning in improving pain control and reducing system burden.
Authors
Abdulbashid Bellakandam
Torbay and South Devon NHS Foundation Trust, Torquay, United Kingdom
Theresa Hinde
Torbay and South Devon NHS Foundation Trust, Torquay, United Kingdom
Jane Pyle
Torbay and South Devon NHS Foundation Trust, Torquay, United Kingdom