Patient-reported outcome measures-guided peri-operative care versus standard of care in postoperative recovery: Randomised controlled trial in orthopaedic surgery.
Manon Eber, Thomas Perrin, Nathalie Reinbold et al.
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In 30 seconds
This single-centre, prospective, pragmatic randomised controlled trial compared PROMs-guided peri-operative care with usual care in 280 adults undergoing osteoarticular surgery at a French university hospital. The intervention used Quality of Recovery-15 assessments to guide care. At postoperative day 35, the mean QoR-15 change was 5.5 points higher with PROMs-guided care (95% credibility interval 2.3 to 9.2), but the probability of exceeding the six-point minimal clinically important difference was 39.4%. Persistent opioid consumption was also less likely in the intervention group.
Key findings
- At postoperative day 35, QoR-15 change was 5.5 points higher with PROMs-guided care (95% credibility interval 2.3 to 9.2).
- The probability that the QoR-15 difference exceeded the six-point minimal clinically important difference was 39.4%.
- Persistent opioid consumption was 12.3% with PROMs-guided care versus 21.2% with usual care; the probability of a relative risk below 1 was 97.4%.
Why it matters
The trial evaluates whether patient-reported recovery measures can inform individual peri-operative care, rather than serving only as research or quality-improvement measures. The findings suggest a possible reduction in persistent opioid use, while the average improvement in reported recovery did not clearly reach the prespecified threshold for clinical importance. Both outcomes are relevant when assessing recovery after osteoarticular surgery.
What to keep in mind
The trial was conducted at a single centre, limiting certainty about applicability to other settings. The probability that the QoR-15 improvement exceeded the minimal clinically important difference was 39.4%.