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Remote smart pill cap monitoring of post-surgical pain management in thyroid and parathyroid surgery

Published:December 29, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.12.020

      Highlights

      • Remote patient monitoring with smart pill caps is a novel way of tracking postoperative pain medication usage.
      • After thyroid and parathyroid surgery, pain scores are highest in the first 24 h and decrease thereafter.
      • After thyroid and parathyroid surgery, patients can rely on non-opioid medications.

      Abstract

      Background

      With recent efforts to decrease opioid use following surgery, this study aims to answer: what pain regimen do patients follow at home? Is it controlling pain?

      Methods

      This is a prospective, pilot study of thyroid and parathyroid surgery patients. Patients were prescribed acetaminophen, ibuprofen, and tramadol dispensed in smart pill (Pillsy) bottles that record “events” corresponding to medication use. Patients received messages querying their current pain level. Patients were compared to historical controls.

      Results

      26 patients were in the Pillsy group and 30 in the control group. In the Pillsy group, pain scores averaged 3.67 out of 10 in the first 24 h after surgery and decreased each day. Patients took an average of 6.45 doses of acetaminophen, 6.64 doses of ibuprofen, and 1.82 doses of tramadol in the first week.

      Conclusions

      Pain scores are highest in the first 24 h after surgery and decrease thereafter. This acceptable level of pain can be achieved with non-opioid medications.

      Graphical abstract

      Keywords

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      References

        • Lou I.
        • Chennell T.B.
        • Schaefer S.C.
        • et al.
        Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
        Ann Surg Oncol. 2017; : 1951-1957https://doi.org/10.1245/s10434-017-5781-y
        • Brummett C.M.
        • Waljee J.F.
        • Goesling J.
        • et al.
        New persistent opioid use after minor and major surgical procedures in US adults.
        JAMA Surg. 2017; 152: e1-e9https://doi.org/10.1001/jamasurg.2017.0504
        • Lide R.C.
        • Creighton E.W.
        • Yeh J.
        • et al.
        Opioid reduction in ambulatory thyroid and parathyroid surgery after implementing enhanced recovery after surgery protocol.
        Head Neck. 2021; 43: 1545-1552https://doi.org/10.1002/hed.26617
        • Shindo M.
        • Lim J.
        • Leon E.
        • Moneta L.
        • Li R.
        • Quintanilla-Dieck L.
        Opioid prescribing practice and needs in thyroid and parathyroid surgery.
        JAMA Otolaryngol - Head Neck Surg. 2018; 144: 1098-1103https://doi.org/10.1001/jamaoto.2018.2427
        • Ruffolo L.I.
        • Jackson K.M.
        • Juviler P.
        • et al.
        Narcotic free cervical endocrine surgery: a shift in paradigm.
        Ann Surg. 2021; 274: e143-e149https://doi.org/10.1097/SLA.0000000000003443
        • Oyler D.R.
        • Randle R.W.
        • Lee C.Y.
        • Jenkins G.
        • Chang P.K.
        • Sloan D.A.
        Implementation of opioid-free thyroid and parathyroid procedures: a single center experience.
        J Surg Res. 2020; 252: 169-173https://doi.org/10.1016/j.jss.2020.03.010
        • Oltman J.
        • Militsakh O.
        • D'Agostino M.
        • et al.
        Multimodal analgesia in outpatient Head and neck surgery.
        JAMA Otolaryngol Neck Surg. 2017; 143: 1207-1212https://doi.org/10.1001/jamaoto.2017.1773
        • Rice D.R.
        • Kaplan T.B.
        • Hotan G.C.
        • et al.
        Electronic pill bottles to monitor and promote medication adherence for people with multiple sclerosis: a randomized, virtual clinical trial.
        J Neurol Sci. 2021; 428117612https://doi.org/10.1016/j.jns.2021.117612
        • Park H.R.
        • Kang H.S.
        • Kim S.H.
        • Singh-Carlson S.
        effect of a smart pill bottle reminder intervention on medication adherence, self-efficacy, and depression in breast cancer survivors.
        Cancer Nurs. 2021; (Publish Ah(00)): 1-9https://doi.org/10.1097/ncc.0000000000001030
        • Uhlmann R.A.
        • Reinhart H.A.
        • Postevka E.
        • Snyder S.K.
        • Romero Arenas M.
        A review of postoperative pain management for thyroid and parathyroid surgery.
        J Surg Res. 2019; 241: 107-111https://doi.org/10.1016/j.jss.2019.03.050
        • Chen Y.
        • Nwaogu I.
        • Chomsky-Higgins K.
        • et al.
        Postoperative pain and opioid use after thyroid and parathyroid surgery—a pilot, prospective SMS-based survey.
        J Surg Res. 2019; 240: 236-240https://doi.org/10.1016/j.jss.2019.03.016
        • Long S.M.
        • Lumley C.J.
        • Zeymo A.
        • Davidson B.J.
        Prescription and usage pattern of opioids after thyroid and parathyroid surgery.
        Otolaryngol Head Neck Surg. 2019; 160: 388-393https://doi.org/10.1177/0194599818779776