Effect of Patient Education on Postoperative Healthcare Resource Utilization and Patient Satisfaction for Patients Receiving Peripheral Nerve Blockade: A Pragmatic Prospective Study

Abstract

Abstract Background Peripheral nerve block (PNB) is associated with high satisfaction but increased postoperative healthcare resource utilization, perhaps due to inadequate communication of expected PNB behavior to patients. We hypothesized pragmatic multimedia education for patients undergoing PNB would decrease unplanned, postoperative PNB-related healthcare resource utilization. Methods This single-center, prospective, before-after, non-randomized study enrolled 600 ambulatory orthopedic surgery patients receiving PNB. In this original research Group 1 (n = 300) received standard education and Group 2 (n = 300) received multimedia education including handouts and videos. The primary outcome was unplanned, PNB-related postoperative healthcare resource utilization (unplanned visit to physician's office or emergency department, or unplanned phone call, relating to pain or problems with the PNB); secondary outcomes included knowledge of PNB. Data analysis used two-sample t-test, Pearson’s chi-square test, or Fisher’s exact test. Results We enrolled 300 patients in each group (N = 600). Follow-up response rates were 76% (Group 1, n = 229) and 82% (Group 2, n = 246). Our main findings indicate there was no significant difference in seeking unplanned PNB-related care in the first 4 days after surgery between Group 1 and Group 2 (14.4% vs 15.5%, respectively, p = 0.75). There was no difference in satisfaction with postoperative pain management and PNB information received between groups (p = 0.37). 90.4% (N = 207/229) in Group 1 and 87.8% (N = 216/246) in Group 2 were satisfied or very satisfied with post op pain management. Mean knowledge test scores were 7.8 (± 1.9) in Group 1 and 8.7 (± 1.3) in Group 2 (p < 0.0001; n = 149 in Group 1 and n = 115 in Group 2). Conclusions Pragmatic multimedia education for PNB did not change rates of unplanned, postoperative PNB-related healthcare resource utilization or satisfaction, although it improved patient knowledge. Further research will be necessary to investigate if the benefits of comprehensive multimedia education provided in the days prior to surgery will outweigh the costs of decreased production throughput and increased resource input in coordination of this patient education program.