PERIoperative Holistic RIsk Factor SCreening in the Prevention of Persistent Pain

Study Overview
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Brief Summary
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Assessment and management for improved wellbeing after elective surgery (PERISCOP³E-Care) Diagnostic assessment tool evaluation and cut-off determination for participation in a transmural perioperative care program

Detailed Description
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Adult patients (≥ 18y) who are planned to undergo an elective surgery at the University Hospital Antwerp, will be invited to participate. After signing the informed consent, they will be asked to complete questionnaires (PERISCOP3E-care; Kalkman & modified-Althaus, DN4, HADS, Stait-trait, NRS, MPIn EQ-5D-5L) that involve screening of the risk to develop persistend postoperative pain (PPSP). The questionnaires will be completed via a survey link to the RedCap platform. Invites will be send out via the patient's e-mail. Demograpic data and relevant medical history, surgery history, concomitant medication will be registered. one month and three months post surgery the patients will be contacted to identicate if they developed PPSP. They will also be asked to complete quesionnaires (MPI, HADS, Stai-Trait, NRS, MPI, DN4). Based on this info, the cut-off value will be defined for the preoperative questionnaire. Analysis will be done for the sensitivity and specificity of the questionnaires.

Official Title
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PERIoperative Holistic RIsk Factor SCreening in the Prevention of Persistent Pain

Conditions
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Pain, Chronic Post-Surgical

Intervention / Treatment
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* Other: PERISCOPE-care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patiënts (≥ 18 year) planned elective surgery @ University Hospital Antwerp Exclusion Criteria: incapacitated cognitive dificit that makes it impossible to complete the questionnaires language barrier

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: PERISCOPE-care|Patients with planned elective surgery will be asked to complete the PERISCOP3E-Care questionnaire (modified-Althaus & Kalkman, DN4, HADS, Stait-trait, NRS, MPI, EQ-5D-5L) preoperative. One month and three months post op the patients will be contacted to check if they developed persistend postoperative pain and they will also complete questionnaires (DN4, HADS, Stait-trait, NRS, MPI and EQ-5D-5L).|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cut-off determination | Cut-off score determination for Kalkman and modified-Althaus risk for the prevention of persistend pain post op. Determination of inclusion and exclusion in the transmural care path | preoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain | Determination with numeric rating schale, NRS (numeric rating scale). Values from 0-10 with 10 being the highest pain you can have. | postoperative (day 0 or 1day post surgery) | 
| Persistent postoperative pain | Determination of persistent postoperative pain via NRS (numeric rating scale). Values from 0-10 with 10 being the highest pain you can have. | 1 month and 3months post surgery | 
| The use of opioids | Need for daily intake of opioids (started postoperative) after surgery | 1month and 3months post surgery | 
| The patients well-being | Evaluation of the well-being measured with EQ-5D-5L questionnaire (5-level EQ-5D version). Each dimension has 5 levels of response. (Level 1); slight; moderate; severe; and extreme problems (Level 5). here are 3,125 possible health states defined by combining one level from each dimension, ranging from 11111 (full health) to 55555 (worst health). | preoperative, 1month and 3months post surgery | 
| Fear and Depression | Evaluate the core complaints of fear and depression (without physical complaints) using the HADS questionnaire. Seven questions related to fear and seven questions related to depression. Every question can be answered with 0-1-2-3. If the score for the questions with fear is >8, this will indicate a psychiatric condition. If the score for the questions related to depression >8, this will indicate a psychiatric condition. | preoperative, 1month and 3months post surgery | 
| State anxiety and fear predisposition | Evaluation of the state anxiety and fear disposition using the Stai-Trait questionnaire. The range of scoring goes from a minimum of 20 untill a maximum score of 80. STAI scores are commonly classified as no or low anxiety (20-37), moderate anxiety (38-44), and high anxiety (45-80) | preoperative, 1month and 3months post surgery | 
| Pain complaints | The MPI questionnaire part 1 measures the impact of pain on an individual's life, quality of social support and general activity. Each item is rated on a 0-6 scale, and the scoreds for each subscale are calculated by adding the score for each item in that subscale, devided by the number of items that subscale to yeald a mean score. | preoperative, 1month and 3months post surgery if the NRS ≥ 3 | 
| Neuropatic pain | Evaluation of the presence of neuropatic pain components using the DN4 quesionnaire. When the score ≥ 4, neuropatic pain is likely. | preoperative, 1month and 3months post surgery if the NRS ≥ 3 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Persistent postoperative pain