Publications by authors named "Winfried MeiSSner"

Background: Pain medicine is an interdisciplinary and interprofessional field of specialisation. Due to concerns about new recruits and an aging workforce, especially among physicians, it is important to better understand professional and career pathways in pain medicine.

Objectives: The aim of this study was to record the occupational routes of people working in an institution specialised in pain medicine/pain management as well as their motivation and job satisfaction.

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Introduction: Complex regional pain syndrome (CRPS) is a rare complication after limb injuries. Early recognition of the symptomatology and interdisciplinary interventions are essential to prevent long-term disability and pain.

Objective: This article presents results on the incidence of CRPS after surgery in Germany and treatments used by patients with CRPS, using claims data from the BARMER, a German nationwide health care insurance.

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Article Synopsis
  • Interdisciplinary multimodal pain therapy (IMPT) is effective for severe chronic pain, but there's limited research on how treatment duration affects outcomes.
  • This study compared the medium-term success of a one-week inpatient treatment (SIT) versus a four-week outpatient treatment (LOT), both having the same weekly therapy intensity.
  • Results showed that while both groups had initial improvements, the LOT group maintained better outcomes at three months, suggesting longer treatment may lead to more stable long-term effects.
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Article Synopsis
  • The study aimed to assess how important different factors like pain intensity, side effects, and personal interactions are to patients versus healthcare professionals (HCP) in managing postoperative pain.* -
  • A questionnaire was used on 40 patients and 63 HCP at Jena University Hospital to evaluate their priorities regarding the quality of pain management.* -
  • Results showed patients prioritized personal interaction, pain intensity, and pain interference more highly than HCP, highlighting a potential gap in understanding between patients' and professionals' perspectives on pain management.*
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Background: The risk of persistent postoperative opioid use (PPOU) and its association with the type of surgery are still unclear in Germany.

Methods: We conducted a nationwide retrospective cohort study on the basis of claims data from BARMER, a statutory health insurance carrier in Germany. Opioid-naive adults who did not have cancer and who underwent inpatient surgery in 2018 were included in the study.

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This observational study aimed to identify predictors of kinesiophobia and examine its correlation with early functional outcomes in TKA recipients. On the first and fifth postoperative days (POD1 and POD5), we evaluated pain using the International Pain Outcomes Questionnaire (IPO-Q) and created multidimensional pain composite scores (PCSs). The Total Pain Composite Score (PCStotal) assesses the overall impact of pain, taking into account outcomes of pain intensity, pain-related interference with function, and emotions and side effects.

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This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and palliative care units. To allow comparability between unit types, a matching was performed for demographic characteristics of staff.

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Article Synopsis
  • Chronic postsurgical pain (CPSP) is a significant issue requiring further research to understand its incidence, characteristics, and risk factors, particularly after various surgeries like breast cancer operations and knee arthroplasties.
  • An extensive observational study involved 3,297 patients from 18 European hospitals, revealing a 6-month CPSP incidence rate of 10.5%, with variations based on surgery type, and highlighting a common occurrence of neuropathic pain symptoms.
  • While the study did not succeed in creating a new predictive score for CPSP, it provided valuable insights into its prevalence and impact on patients' quality of life following different surgical procedures.
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Objectives: Determination of the procedure-specific, risk-adjusted probability of nausea.

Design: Cross-sectional analysis of clinical and patient-reported outcome data. We used a logistic regression model with type of operation, age, sex, preoperative opioids, antiemetic prophylaxis, regional anaesthesia, and perioperative opioids as predictors of postoperative nausea.

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Background: Long-term opioid use after surgery is a crucial healthcare problem in North America. Data from European hospitals are scarce and differentiation of chronic pain has rarely been considered.

Methods: In a mixed surgical cohort of the PAIN OUT registry, opioid use and chronic pain were evaluated before surgery, and 6 and 12 months after surgery (M6/M12).

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Background: Pain is the leading cause of disability worldwide among adults and effective treatment options remain elusive. Data harmonization efforts, such as through core outcome sets (COS), could improve care by highlighting cross-cutting pain mechanisms and treatments. Existing pain-related COS often focus on specific conditions, which can hamper data harmonization across various pain states.

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Background: Postsurgical outcome measures are crucial to define the efficacy of perioperative pain management; however, it is unclear which are most appropriate. We conducted a prospective study aiming to assess sensitivity-to-change of patient-reported outcome measures assessing the core outcome set of domains pain intensity (at rest/during activity), physical function, adverse events, and self-efficacy.

Methods: Patient-reported outcome measures were assessed preoperatively, on day 1 (d1), d3, and d7 after four surgical procedures (total knee replacement, breast surgery, endometriosis-related surgery, and sternotomy).

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Cesarean section (CS) is the most widely performed and one of the most painful surgeries. This study investigated postoperative pain after CS using patient-related outcomes (PROs) to identify risk factors for severe pain. The secondary outcome was to evaluate the influence of surgery indication (primary CS (PCS) vs.

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Article Synopsis
  • * A study evaluated data from over 330,000 patients to determine the prevalence of significant incisional pain post-surgery, finding an overall rate of 22.5%, with variations based on the type of surgery.
  • * Key factors linked to higher pain levels included younger age, early postoperative pain, insufficient pain relief, and surgical infections, impacting patient satisfaction and work recovery.
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Background: Multi-professional specialist palliative homecare (SPHC) teams care for palliative patients with complex symptoms. In Germany, the SPHC directive regulates care provision, but model contracts for each federal state are heterogeneous regarding staff requirements, cooperation with other healthcare providers, and financial reimbursement. The structural characteristics of SPHC teams also vary.

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To assess postoperative pain intensity in adults, the numeric rating scale (NRS) is used. This scale has shown acceptable psychometric features, although its scale properties need further examination. We aimed to evaluate scale properties of the NRS using an item response theory (IRT) approach.

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Introduction: The Perioperative Pain Management Bundle was introduced in 10 Serbian PAIN OUT network hospitals to improve the quality of postoperative pain management. The Bundle consists of 4 elements: informing patients about postoperative pain treatment options; administering a full daily dose of 1-2 non-opioid analgesics; administering regional blocks and/or surgical wound infiltration; and assessing pain after surgery. In this study, we aimed to assess the cost-effectiveness of the Bundle during the initial 24 h after surgery.

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Objectives: The quality of postoperative pain management is often poor. A "bundle," a small set of evidence-based interventions, is associated with improved outcomes in different settings. We assessed whether staff caring for surgical patients could implement a "Perioperative Pain Management Bundle" and whether this would be associated with improved multidimensional pain-related patient-reported outcomes (PROs).

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Article Synopsis
  • Modern ophthalmology offers various surgical procedures, necessitating effective pain management strategies.
  • Identifying established risk factors for severe postoperative pain is crucial for improving perioperative care.
  • A collaborative approach among healthcare providers is essential to incorporate effective pain management into the treatment plan prior to surgery.
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Purpose: To determine whether the preoperative inflammatory serum C-reactive protein (CRP) and leukocyte count (LEUK) are associated with postoperative pain and complaints after otolaryngological surgery.

Methods: Retrospective evaluation of 680 patients (33% female, median age 50 years) receiving otolaryngological surgery between November 2008 and March 2017 in a tertiary university hospital. Postoperative pain on the first postoperative day was assessed using the validated questionnaire of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale for assessment of postoperative pain (NRS, 0-10).

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Background: The S1 guideline on long/post-COVID of the AWMF [German Association of the Medical Scientific Societies] registration number 020-027) was updated in August 2022.

Methods: Under the coordination of the German Society of Pneumology, the guideline was updated by 21 scientific associations, two professional associations and clinical centers each and one institute and statutory accident insurance each. Each scientific association was responsible for its own chapter.

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Background: In Germany, palliative care (PC) is provided on a homecare, inpatient, general, and specialized basis. Since little is currently known about the temporal course and regional differences in the forms of care, the present study was aimed to investigate this.

Method: In a retrospective routine data study with 417,405 BARMER-insured persons who died between 2016 and 2019, we determined the utilization rates of primary PC (PPC), specially qualified and coordinated palliative homecare (PPC+), specialized palliative homecare (SPHC), inpatient PC, and hospice care on the basis of services billed at least once in the last year of life.

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Women who have had a Cesarean Section (CS) frequently report severe pain and pain-related interference. One reason for insufficient pain treatment might be inconsistent implementation of evidence-based guidelines. We assessed the association between implementing three elements of care recommended by guidelines for postoperative pain management and pain-related patient-reported outcomes (PROs) in women after CS.

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