Original Article

PAIN OUT: an international acute pain registry supporting clinicians in decision making and in quality improvement activities

1. Ruth Zaslansky DSc Researcher^1,*,
2. Judith Rothaug PhD Clinician and Researcher¹,
3. Richard C. Chapman PhD Researcher²,
4. Ragnar Backström MD Clinician and Researcher³,
5. Silviu Brill MD Clinician and Researcher⁴,
6. Christoph Engel MD Researcher⁵,
7. Dominique Fletcher MD Clinician and Researcher⁶,
8. Lucian Fodor MD Clinician and Researcher⁷,
9. Peter Funk PhD Researcher⁸,
10. Debra Gordon DNP Clinician and Researcher⁹,
11. Marcus Komann PhD Researcher,
12. Christoph Konrad MD Clinician and Researcher¹⁰,
13. Andreas Kopf MD Clinician and Researcher¹¹,
14. Yigal Leykin MD Clinician and Researcher¹²,
15. Esther Pogatzki-Zahn MD Clinician and Researcher¹³,
16. Margarita Puig MD PhD Clinician and Researcher¹⁴,
17. Narinder Rawal MD PhD Clinician and Researcher³,
18. Matthias Schwenkglenks PhD Researcher¹⁵,
19. Rod S. Taylor PhD Researcher¹⁶,
20. Kristin Ullrich MD Clinician and Researcher¹⁷,
21. Thomas Volk MD Clinician and Researcher¹⁸,
22. Maryam Yahiaoui-Doktor MSc Researcher⁵ and
23. Winfried Meissner MD Clinician and Researcher¹

Article first published online: 1 JUL 2014

Journal of Evaluation in Clinical Practice

Abstract

Rationale, aims and objectives

Management of post-operative pain is unsatisfactory worldwide. An estimated 240 million patients undergo surgery each year. Forty to 60% of these patients report clinically significant pain. Discrepancy exists between availability of evidence-based medicine (EBM)-derived knowledge about management of perioperative pain and increased implementation of related practices versus lack of improvement in patient-reported outcomes (PROs). 
We aimed to assist health care providers to optimize perioperative pain management by developing and validating a medical registry that measures variability in care, identifies best pain management practices and assists clinicians in decision making.

Methods

PAIN OUT was established from 2009 to 2012 with funding from the European Commission. It now continues as a self-sustaining, not-for-profit project, targeting health care professionals caring for patients undergoing surgery.

Results

The growing registry includes data from 40 898 patients, 60 hospitals and 17 countries. Collaborators upload data (demographics, clinical, PROs) from patients undergoing surgery in their hospital/ward into an Internet-based portal. Two modules make use of the data: (1) online, immediate feedback and benchmarking compares PROs across sites while offline analysis permits in-depth analysis; and (2) the case-based clinical decision support system offers practice-based treatment recommendations for individual patients; it is available now as a prototype. The Electronic Knowledge Library provides succinct summaries on perioperative pain management, supporting knowledge transfer and application of EBM.

Conclusion

PAIN OUT, a large, growing international registry, allows use of ‘real-life’ data related to management of perioperative pain. Ultimately, comparative analysis through audit, feedback and benchmarking will improve quality of care.