PATIENT ATTITUDES REGARDING PCA AND ASSOCIATED COSTS

Purpose: To determine patients' knowledge and attitudes towards patien t-controlled analgesia,(PCA) costs through the use of our acute pain s ervice quality assurance (QA) programme. Methods: Quality Assurance qu estionnaires were distributed to all patients receiving PCA opioids fo r >12 hr. Patients were asked to note the presence of side effects (na usea/vomiting, pruritus, urinary retention), to indicate their satisfa ction with regard to their pain relief, follow-up assessments, treatme nt of side effects, and to recall the previous method of pain relief a nd their satisfaction with it. Patients were also asked to estimate th e total cost of PCA (0-$50, $50-100, $100-200, >$200), and what amount if any they would be willing to pay (0-$50, $50-100, $100-200, >$200) . Results obtained over a recent four month period were reviewed. Resu lts: One hundred and thirty-three questionnaires were distributed and 103 (77%) were returned. The percentage of patients rating their satis faction as very good or excellent was 86% for pain relief, 96% for fol low-up, 71% for side effect treatment, but only 43% for their previous surgical pain relief (P<0.001). The distribution of cost estimates wa s 10% $50-100, 37% $100-200 and 53% >$200 with 60% willing to pay a po rtion of this cost. Those willing to pay were more likely to have had very good or excellent pain relief (94% vs 71%, P<0.05) and treatment of side effects (71% vs 48%, P<0.05) than those not willing to pay. Co nclusions: Patients continue to be highly satisfied with PCA therapy a nd are aware of the costs involved. A majority of patients were willin g to pay to obtain this service if necessary. Patients who had poorer pain relief and less efficacious treatment of their side effects were less willing to pay.