Meta-Analysis of the Ease of Care From a Patients' Perspective Comparing Fentanyl Iontophoretic Transdermal System Versus Morphine Intravenous Patient-Controlled Analgesia in Postoperative Pain Management
| Autor: | Lindley, Pam, Ding, Li, Danesi, Hassan, Jones, James B. |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Inpatients endocrine system diseases Attitude of Health Personnel Analgesia Patient-Controlled iontophoretic transdermal system Iontophoresis Middle Aged Nursing Staff Hospital patient global assessment of the method of pain control Administration Cutaneous Analgesics Opioid Fentanyl patient-controlled analgesia 03 medical and health sciences Medical–Surgical Nursing 0302 clinical medicine Medical–Surgical Humans Pain Management Female 030212 general & internal medicine ease-of-care Infusions Intravenous 030217 neurology & neurosurgery |
| Zdroj: | Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 32(4) |
| ISSN: | 1532-8473 |
| Popis: | PurposeThe purpose of this meta-analysis was to evaluate patients' assessment of fentanyl iontophoretic transdermal system (ITS) and morphine intravenous patient-controlled analgesia (IV PCA) ease of care (EOC) using a validated patient EOC questionnaire. Fentanyl ITS is a preprogrammed, needle-free PCA system used for the management of acute pain in postoperative patients.MethodsThis meta-analysis assessed the patient EOC of fentanyl ITS and morphine IV PCA using data from three randomized, active-comparator trials in adult postoperative patients with moderate-to-severe pain. All three studies utilized a validated patient EOC questionnaire which consists of 23 items grouped into seven subscales (confidence with device, comfort with device, movement, dosing confidence, pain control, knowledge/understanding, and satisfaction). Each item is scored on a six-point Likert scale. The weighted mean difference between treatments was calculated for the overall EOC and for each of the seven subscales.ResultsThe EOC analyses were based on responses to questionnaires from 1,943 patients treated with either fentanyl ITS (n = 961) or morphine IV PCA (n = 982). There was a statistically significant advantage in favor of fentanyl ITS over morphine IV PCA in terms of overall EOC (weighted mean difference = 0.28; 95% confidence interval (0.22 to 0.34); P < 0.0001). Five of the seven subscales (confidence with device, comfort with device, movement, dosing confidence, and knowledge/understanding) on the patient EOC questionnaire showed a statistically significant advantage for fentanyl ITS versus morphine IV PCA. The two subscales that did not show any difference were pain control (P = 0.7303) and satisfaction (0.0561).ConclusionIn this meta-analysis, fentanyl ITS is associated with some advantages in terms of an EOC profile from a patients' perspective when compared with morphine IV PCA. |
| Databáze: | OpenAIRE |
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