Patients and Prescribers Diverge on Pain Expectations
PATIENTS and prescribers often have mismatched expectations about pain management following total hip or knee replacement surgery. This is according to a new qualitative study exploring attitudes toward opioid use after discharge. The research revealed that inconsistent prescribing practices and vague patient instructions contribute to confusion and anxiety during postoperative recovery.
Through semi-structured interviews with 20 prescribers and 13 patients, researchers identified distinct but overlapping concerns. While clinicians emphasized balancing pain control against the risks of opioid dependence, many patients expected closely monitored, evidence-based pain management that minimized harm and uncertainty.
Pain Management Practices Lack Standardization
Prescribers reported a “patchwork” of approaches influenced by institutional norms and personal experience rather than standardized guidelines. Many clinicians prioritized practical, experience-based judgments over formal recommendations, reflecting a gap between policy and real-world practice. This variability, the authors noted, can lead to differing patient outcomes and inconsistent pain relief after discharge.
Opioid Use Creates Anxiety for Patients
For patients, postoperative recovery was marked by uncertainty about how to manage prescribed opioids. Some expressed fear of addiction or side effects, while others were more anxious about undertreated pain. These concerns were compounded by limited guidance on dosage, duration, and tapering. As a result, patients often adjusted their use independently, leading to variable adherence and outcomes.
Need for Clearer Guidance and Communication
The findings underscore the importance of aligning expectations between patients and prescribers to optimize post-surgical pain management. Improved discharge protocols, transparent discussions about pain trajectories, and consistent education on opioid use may help bridge the communication gap and support safer recovery after total hip or knee replacement.
Reference: Liang I et al. Expectations about pain management after discharge from total hip and knee replacement surgery: a qualitative study with patients and prescribers. Front Pain Res (Lausanne). 2025;6:1647020.
