Patient‐reported outcomes, postoperative pain and pain relief after day‐case surgery ( <scp>POPPY</scp> ): short‐term peri‐operative analgesic use

Summary Introduction An increasing proportion of complex surgical procedures are being performed in the UK as day‐cases, with variable and limited follow up. Discharge prescriptions must provide adequate analgesia, while considering the safety of the patient and public, following best practice guidance and good opioid stewardship. Methods Data were collected by the POPPY study, a national, prospective, observational study measuring short‐ and longer‐term patient‐reported outcomes relating to postoperative pain and pain relief after day‐case surgery in adults. We aimed to describe pre‐operative and early postoperative analgesia in the first 7 days following surgery alongside describing prescribing practices; analgesic use; patient satisfaction with pain relief; and the need for further healthcare support for pain management. Results Of the 7839 patients recruited, 1985 (25.3%) were taking opioid analgesics pre‐operatively, of whom 1366 (68.8%) reported pain of more than 3 months duration. After surgery, 3628 (46.4%) patients received opioid analgesics and 1229 (25.9%) reported taking opioid analgesics on day 7. Of those patients prescribed opioids after surgery, 474 (22.8%) reported never taking them. Over three‐quarters of patients (3876, 76.7%) reported being satisfied with their analgesia, but 922 (18.2%) sought further help for pain relief, most commonly from their GP. Patients taking postoperative opioids reported higher pain scores; lower satisfaction scores; lower quality of recovery scores; and had higher rates of seeking help to manage pain after discharge. Discussion Most patients were satisfied with pain relief after surgery but a large proportion were still taking opioid medications on day 7. Nearly 1 in 5 patients sought additional help for pain relief, potentially constituting a significant burden on community health services. These findings suggest improvements could be made in the systems for day‐case patient support after discharge.