The Effect of an Individualized Education Intervention on Pain Following Inguinal Hernia Repair Surgery
Condition: Pain
MeSH terms: Hernia; Hernia, Inguinal
Study type: Interventional
Phase: Early Phase 1

Summary: 
      Pain after inguinal hernia repair surgery is common with more than 50% of patients reporting
      moderate to severe acute pain following surgery. Analgesics are helpful in managing this pain
      but patients can be reluctant to take analgesics due to potential adverse effects such as
      nausea, vomiting or constipation. Patients may also be concerned about addiction to
      analgesics or they may believe that experiencing moderate to severe pain after surgery is to
      be expected.

      The purpose of this study is to investigate the impact of an individualized education program
      regarding pain and management of adverse effects on pain after inguinal hernia repair
      surgery.
    

Detailed description: 
      There is clear evidence that patients who have undergone ambulatory inguinal hernia (IHR)
      repair have significant pain following surgery. Inguinal hernia repair has been identified as
      one of the most painful ambulatory surgery procedures, with 98% of patients reporting pain 24
      hours following IHR surgery, and 54% of patients experiencing moderate to severe pain in the
      first 72 hours. Despite experiencing continued pain, patients do not always take the
      prescribed analgesics. Analgesics are helpful in managing post-operative pain but may have
      adverse effects, including nausea, vomiting or constipation, which are often not managed.
      Almost half of all patients who undergo ambulatory surgery experience these adverse effects
      with 45% experiencing constipation and 46% experiencing nausea and/or vomiting in the first
      48 hours after surgery.

      As well, patients may have concerns about addiction, or asking for help to manage their pain
      and may believe that moderate to severe pain is to be expected, contributes to healing and
      therefore is to be tolerated following surgery. Patients are expected to manage this pain and
      adverse effects of analgesics at home. Minimal research has been found regarding
      interventions to manage pain following ambulatory surgery, and none found specifically for
      patients undergoing inguinal hernia repair.

      The purpose of this trial is to investigate the impact of an individualized pre-operative
      pain education intervention that includes a booklet with telephone support pre-operatively
      and after discharge home versus usual care for patients having IHR surgery. The primary
      outcome will be worst pain on movement in the past 24 hours and the secondary outcomes will
      be pain related interference, pain quality, analgesic use and adverse effects, and patient
      satisfaction and concerns with pain management.
    

Intervention name(s): Individualized Education
Intervention type(s): Behavioral
Intervention description(s): The intervention consists of written information in the form of a booklet, an individualized face to face education session and two telephone support calls regarding post-discharge pain management, adverse effects of analgesics and common concerns about asking for help with pain.Participants in the intervention group will also receive two telephone support calls. The purpose of the telephone support calls is to readdress the information that patients received in the booklet and to clarify concerns regarding post-operative pain management that were discussed during the individualized education session.
Other intervention name(s): inginal hernia repair; acute pain
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Post-operative pain; inguinal hernia repair surgery; Patient education