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International Journal of Clinical Pharmacy

, Volume 39, Issue 1, pp 133–138 | Cite as

Patients’ understanding and use of analgesia for postnatal pain following hospital discharge

  • Antonia M. W. Wong
  • Syed Tabish R. ZaidiEmail author
Research Article

Abstract

Background Postnatal pain is one of the limiting factors in the recovery of women from child birth. Despite the routine prescribing of analgesics for postnatal pain, limited research is available on the use of analgesics by the women in postnatal period. Objective To measure the utilisation and effectiveness of prescribed oral analgesics, the incidence and severity of pain, and factors associated with poor pain control on the fifth-day post-hospital discharge in postnatal women. Setting A tertiary referral women’s hospital of Western Australia. Method Prospective cohort follow-up study of 400 postnatal women at a tertiary referral women’s hospital during May and July 2014. All eligible subjects were contacted for a telephone survey 5 days after their discharge from the hospital. Additional clinical data was collected from the hospital medical records. Main outcome measure Pain at discharge, analgesics prescribed on discharge, patient understanding and adherence, and postnatal pain management. Results 197 of 400 recruited women completed the telephone survey yielding a response rate of around 50%. 131 Women (66%) reported to be in pain at the fifth-day post-hospital discharge. Older women (p = 0.003) and women who reported to be in pain at hospital discharge were more likely to experience pain at home (p = 0.001). Women were more likely to seek consultation from a healthcare professional (p = 0.001) prior to their scheduled follow up visit, purchase over the counter analgesics from pharmacy (p = 0.012) and seek non-drug alternative (p = 0.019) if they experienced pain at home. Conclusion Pain at hospital discharge was found to be a strong predictor of pain at home among the postnatal women in this study. We propose pain at the time of hospital discharge as a useful clinical indicator to identify postnatal women who need additional support to manage their pain at home thus minimising potential harm related to inappropriate use of medications.

Keywords

Analgesics Australia Hospital discharge Medicine use Pain management Postnatal pain 

Notes

Acknowledgements

We would like to acknowledge Mr Patrick Yapp, Chief Pharmacist at the King Edward Memorial Hospital for Women for supporting the study. Ms Monica Sajogo and Ms Holly Phillips for their assistance in the administration of the study questionnaires.

Funding

None.

Conflicts of interest

None.

Supplementary material

11096_2016_410_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 kb)

References

  1. 1.
    East CE, Sherburn M, Nagle C, Said J, Forster D. Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. Midwifery. 2012;28(1):93–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Amorim Francisco A, Junqueira Vasconcellos de Oliveira SM, Barbosa da Silva FM, Bick D, Gonzalez Riesco ML. Women’s experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil. Midwifery. 2011;27(6):e254–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Eshkevari L, Trout KK, Damore J. Management of postpartum pain. J Midwifery Women’s Health. 2013;58(6):622–31.CrossRefGoogle Scholar
  4. 4.
    Meyer M, Paranya G, Norris A, Howard D. Intrapartum and postpartum analgesia for women maintained on buprenorphine during pregnancy. Eur J Pain. 2010;2010(14):939–43.CrossRefGoogle Scholar
  5. 5.
    Anderson F, Johnson CT. Complimentary and alternative medicine in obstetrics. Int J Gynaecol Obstet. 2005;2005(91):116–24.CrossRefGoogle Scholar
  6. 6.
    Declercq E, Cunningham DK, Johnson C, Sakala C. Mothers’ reports of postpartum pain associated with vaginal and cesarean deliveries: results of a national survey. Birth. 2008;35(1):16–24.CrossRefPubMedGoogle Scholar
  7. 7.
    Huang K, Tao F, Liu L, Wu X. Does delivery mode affect women’s postpartum quality of life in rural China? J Clin Nurs. 2011;21:1534–43.CrossRefPubMedGoogle Scholar
  8. 8.
    Eisenach J, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TH. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008;2008(140):87–94.CrossRefGoogle Scholar
  9. 9.
    Rowlands IJ, Redshaw M. Mode of birth and women’s psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth. 2012;12:138.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Thompson JF, Roberts CL, Currie M, Ellwood DA. Prevalence and persistence of health problems after childbirth: associations with parity and method of birth. Birth. 2002;29(2):83–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Jardri R, Maron M, Delion P, Thomas P. Pain as a confounding factor in postnatal depression screening. J Psychosom Obstet Gynaecol. 2010;31(4):252–5.CrossRefPubMedGoogle Scholar
  12. 12.
    PANDA. Deloitte Access E, Post, Antenatal Depression A. Cost of perinatal depression in Australia: final report/[prepared for] Post and Antenatal Depression Association; [prepared by] Deloitte Access Economics. North Fitzroy, Vic., 2012.Google Scholar
  13. 13.
    Bush TM, Rayburn KS, Holloway SW, Sanchez-Yamamoto DS, Allen BL, Lam T, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med. 2007;13(2):30–5.PubMedGoogle Scholar
  14. 14.
    Fontana RJ, Adams PC. “Unintentional” acetaminophen overdose on the rise: who is responsible? Can J Gastroenterol. 2006;20(5):319–24.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yoon E, Babar A, Choudhary M, Kutner M, Pyrsopoulos N. Acetaminophen-induced hepatotoxicity: a comprehensive update. J Clin Transl Hepatol. 2016;4(2):131–42.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Fabris L. Persistent post-partum pain after vaginal birth and cesarean section. Period biol. 2011;113(2):239–41.Google Scholar

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  1. 1.Department of Pharmacy ServicesKing Edward Memorial Hospital for WomenSubiaco, PerthAustralia
  2. 2.Pharmacy, School of MedicineUniversity of TasmaniaHobartAustralia

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