“Science tells us what we can do; guidelines what we should do; registries what we are actually doing.”1
At least half of patients who have undergone surgery suffer from post-operative pain which is often moderate-to-severe.2 Therefore the importance and necessity of optimised pain therapy is obvious. Optimised treatment should include evidence-based therapy adapted to the individual needs of the patients.
In trying to improve both the efficacy and tolerability of pain treatment, registries can help improve patient treatment. A registry is a system that collects clinical and other data to evaluate specified outcomes for a defined population.3 Registries do not compete with randomised controlled trials (RCT) but complement them. RCTs generate information from a rather selective patient group and in very specific settings; they do not show real life.3 Consequently, transferring their results into clinical practice is often difficult, if not sometimes impossible.
Registries use a different, more comprehensive approach. They include a representative sample of all patients and therefore show what actually happens with patient care. Pain registries offer analyses of different sub-groups, assessment of side-effects from certain therapies, and often include patient groups that are never addressed by RCTs. PAIN OUT is an example of an acute pain registry which allows ongoing monitoring and feedback.4 It is an important tool for quality assurance and for assessing the efficacy of new pain therapies. Registries often need continuous funding. If they are to have an impact on quality of care in everyday practice, they must be user-friendly and there should be a comprehensive quality management process in place for both institutions and healthcare professionals.