Postoperative pain remains an unresolved problem. On the other hand, over-reliance on opioids contributed to the so-called opioid epidemic [1,2]. But, surprisingly, pain and opioid use after surgery are variably well documented and described. Our team identified a knowledge gap in terms of strategies for managing acute and persistent postoperative pain, including long-term opioid use after surgery . Filling this knowledge gap has been considered a priority by the European Society of Anaesthesiology and Intensive Care (ESAIC). Therefore, ESAIC decided to support the Pain AND Opioids After Surgery (PANDOS) study and to endorse the establishment of the PANDOS ESAIC Research Group, both coordinated within the IAHS Epidemiology group. The current thesis project aims to work on PANDOS studies, aimed at documenting, describing and improving the quality and safety of pain management after surgery.
The first objective will be the PANDOS study, an observational study aimed at documenting the use of perioperative opioids and its safety in Europe (WHO’s definition of Europe) and at describing its association with adverse events and persistent pain. In a one-week prospective cohort study, data on the management of perioperative pain will be collected from all eligible hospitalized adult patients who undergo surgery at as many hospitals as possible in Europe. Anonymized data will be collected via eCRFs, using REDCap software. One week, 3 and 12 months after the study week, a follow-up will be carried out. The primary outcome will be the amount of any opioid used during the preoperative month (preoperative use), during surgery, after three months, and until the end of the postoperative year. Secondary endpoints will include the incidence of pain preoperatively, and at the end of the third postoperative month (persistent pain with / without the presence of neuropathic components). The potential association between opioid use and effects on pain will be investigated.
The amount of data and geographic richness will pave the way for unprecedented generalizable results, but also for sub-studies examining risk factors for unfavourable outcomes. But, more than that, PANDOS is a comprehensive research programme, designed to improve outcomes.
PANDOS-2, based on PANDOS and the Delphi study, will test, in a cluster-randomized implementation trial, a set of best practices aimed at addressing the issues identified previously. These problems may differ from country to country, and from centre to centre, justifying different strategies (e.g. insufficient access to pain management, inappropriate use of opioids, underdeveloped or inappropriate care pathways). But, if the issues may be different, the tool will be the same (set of good practices), allowing the development of tailored quality improvement programmes related to pain management, specific to each participating hospital, and applicable to all operated patients.
The scope of the PhD project, while aiming to improve the management of acute and persistent pain after surgery and whether this may have an impact on the opioid crisis, will be discussed with the candidate. The project will be adapted according to specific interests and proposals of the candidate and, potentially, to newly identified research questions.
Candidates should contact the lead supervisor (Professor Patrice Forget) to discuss the project in advance of submitting an application, as supervisors will be expected to provide a letter of support for suitable applicants. Candidates will be informed after the application deadline if they have been shortlisted for interview.
International applicants are eligible to apply for this studentship but will have to find additional funding to cover the difference between overseas and home fees (approximately £17,000 per annum)
- Formal applications can be completed online: https://www.abdn.ac.uk/pgap/login.php
- You should apply for the Degree of Doctor of Philosophy in Applied Health Sciences to ensure your application is passed to the correct team
- Please clearly note the name of the supervisor and exact project title on the application form. If you do not mention the project title and the supervisor on your application it will not be considered for the studentship.
- Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2:1 Honours degree may be considered provided they have a Distinction at Masters level.
- General application enquiries can be made to [Email Address Removed]