Patient‐reported outcomes, postoperative pain and pain relief after day case surgery (POPPY): methodology for a prospective, multicentre observational study*

Summary Background In the UK, approximately 70% of surgical procedures are undertaken as day‐cases. Little information exists about recovery from day‐case surgery, yet international data highlights patients are at risk of developing significant longer‐term health problems including chronic post‐surgical pain and persistent postoperative opioid use. The Patient‐reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short‐ and longer‐term patient‐reported outcomes, postoperative pain and pain relief after day‐case surgery. Methods This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day‐case surgical patients were recruited on the day of surgery. Baseline data including patient characteristics; procedure details; pre‐operative analgesic use; pre‐existing pain; and quality of life scores were recorded. Patients were followed up through automated short message service messages. Short‐term (postoperative days 1, 3 and 7) outcomes included: quality of recovery; pain severity; impact of pain on function; and analgesic use. Longer‐term outcomes (postoperative day 97) included: quality of life; analgesic use; incidence of chronic post‐surgical pain; and incidence persistent postoperative opioid use. Additional outcomes were completed by those patients with chronic post‐surgical pain and persistent postoperative opioid use, with 30 patients recruited to a qualitative semi‐structured interview study exploring postoperative expectations, recovery, postoperative pain and opioid use. Results An embedded pilot study at four sites recruited 129 patients. Responses to the automated short message service were gained from 129 patients (100%) at day 1; 116 (89.9%) at day 3; 108 (83.7%) at day 7; and 77 (59.7%) at day 97 postoperatively. The pilot enabled refinement of the methods and processes before the national roll out. Conclusion This paper outlines the methods for the POPPY study, the largest UK multicentre prospective observational study considering short‐ and longer‐term outcomes following day‐case surgery.