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Trial registered on ANZCTR
Registration number
ACTRN12619000689178
Ethics application status
Approved
Date submitted
5/05/2019
Date registered
8/05/2019
Date last updated
8/05/2019
Date data sharing statement initially provided
8/05/2019
Date results provided
8/05/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomized Controlled Trial of the impact of pain relief checklists on pain outcomes in patients after a hemorrhoidectomy
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Scientific title
Randomized Controlled Trial of the impact of post-hemorrhoidectomy pain relief checklists on pain outcomes
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Secondary ID [1]
298118
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Nil known
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Universal Trial Number (UTN)
None
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
post-hemorrhoidectomy pain
312648
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Condition category
Condition code
Surgery
311144
311144
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0
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Other surgery
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Oral and Gastrointestinal
311225
311225
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Brief Name of intervention: Post-hemorrhoidectomy pain relief checklist
Patients were recruited by the colorectal surgeon performing their hemorrhoidectomy who gave the patient an envelope that had been allocated to either the control group or intervention (checklist) group. The surgeon was blinded to the allocation of the envelope. If the patient received an envelope that allocated them to the checklist group, then they would receive a visual analogue scale form and a checklist of their post-operative pain medications contained within it. They were to record their levels of pain on the visual analogue scales at 3 specified times each day and fill out the checklist as they took their medications for 14 days after their hemorrhoidectomy. This was done in the patient's own home. Once complete, they were also provided with an envelope addressed to our collection centre to mail their forms to.
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Intervention code [1]
314342
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Behaviour
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Comparator / control treatment
The control group was also recruited by the colorectal surgeon performing their hemorrhoidectomy who gave the patient an envelope, while blinded, that allocated them to the control group. Their envelope contained the same visual analogue scale form as the checklist/intervention group but without a checklist. They also received the same post-operative pain medications as the checklist group and were also asked to record their levels of pain on the visual analogue scales at 3 specified times each day as they took their medications for 14 days after their hemorrhoidectomy. This was done in the patient's own home. Once complete, they were also provided with an envelope addressed to our collection centre to mail their forms to.
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Control group
Active
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Outcomes
Primary outcome [1]
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Daily mean pain and overall mean pain across the 14 days post-operatively for each patient as assessed by visual analogue scale
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Assessment method [1]
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Timepoint [1]
319931
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Assessed daily for 14 days post-haemorrhoidectomy
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Secondary outcome [1]
369922
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Nil
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Assessment method [1]
369922
0
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Timepoint [1]
369922
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Nil
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Eligibility
Key inclusion criteria
participants undergoing an open hemorrhoidectomy for third or fourth degree hemorrhoids at Concord Repatriation General Hospital and Macquarie University Hospital in Sydney, Australia between August 2017 and November 2018
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnant women, children under 18
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque numbered envelopes were used for allocation concealment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation was conducted using ‘Graphpad Random Group Allocator’ to randomly allocate 100 numbered envelopes evenly into either a control group or a checklist treatment group
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Prior to commencement of the study, a sample size calculation performed using PASS Power Analysis Software determined that 27 participants would be required on each arm of the experiment to show 1 SD difference between the two groups with a power level of 0.8, significance level (a) of 0.05 and size of worthwhile difference of 7 on the VAS.
Statistical analysis was conducted utilising a multiple regression model in SPSS software (IBM Corp. 2017) with the dependent variable being ‘mean pain’ and the independent variables being ‘day’ and ‘group’. Differences in mean pain between the two groups on each day as well as differences in overall mean pain for each group were calculated with 95% confidence intervals.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
21/08/2017
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Date of last participant enrolment
Anticipated
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Actual
25/06/2018
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Date of last data collection
Anticipated
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Actual
6/11/2018
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Sample size
Target
54
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Accrual to date
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Final
35
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
13681
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Concord Repatriation Hospital - Concord
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Recruitment hospital [2]
13682
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Macquarie University Hospital - Macquarie Park
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Recruitment postcode(s) [1]
26365
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2139 - Concord
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Recruitment postcode(s) [2]
26366
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2109 - Macquarie Park
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Funding & Sponsors
Funding source category [1]
302651
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Hospital
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Name [1]
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Concord Repatriation General Hospital
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Address [1]
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Concord Repatriation General Hospital
Hospital Road, Concord NSW 2139
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Country [1]
302651
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Australia
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Funding source category [2]
302701
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Hospital
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Name [2]
302701
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Macquarie University Hospital
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Address [2]
302701
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3 Technology Pl, Macquarie University NSW 2109
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Country [2]
302701
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Australia
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Primary sponsor type
Individual
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Name
Matthew Rickard
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Address
Concord Repatriation General Hospital
Medical Centre, Level 1, Suite 102 Hospital Road, Concord NSW 2139
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Country
Australia
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Secondary sponsor category [1]
302568
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Individual
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Name [1]
302568
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Johnny Huang
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Address [1]
302568
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Concord Repatriation General Hospital
Medical Centre, Level 1, Suite 102 Hospital Road, Concord NSW 2139
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Country [1]
302568
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303275
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Sydney Local Health District Human Research Ethics Committee-Concord Repatriation General Hospital
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Ethics committee address [1]
303275
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Concord Repatriation General Hospital Building 20, Hospital Road Concord, NSW, 2139
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Ethics committee country [1]
303275
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Australia
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Date submitted for ethics approval [1]
303275
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13/03/2017
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Approval date [1]
303275
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21/04/2017
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Ethics approval number [1]
303275
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HREC/17/CRGH/19
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Ethics committee name [2]
303281
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Macquarie University Human Research Ethics Committee
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Ethics committee address [2]
303281
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Suite 407, Level 4, F10A Building 2 Technology Place Macquarie University, NSW 2109, Australia
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Ethics committee country [2]
303281
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Australia
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Date submitted for ethics approval [2]
303281
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14/06/2017
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Approval date [2]
303281
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07/08/2017
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Ethics approval number [2]
303281
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MQCRG2017003
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Summary
Brief summary
A major concern regarding hemorrhoidectomy is the considerable post-operative pain experienced by patients for up to 14 days after surgery. Current pain management after a hemorrhoidectomy involves a 2 week extensive course of analgesics. However, a lack of adherence to such an extensive treatment plan may result in suboptimal pain relief. This randomised controlled trial aims to determine if patients who receive a checklist of their prescribed medications which they must tick off each day (checklist group) experience better pain relief than patients who receive the same medications without a checklist (control group). We hypothesised that participants in the checklist group would experience better pain relief compared to the control group due to the checklist helping them keep track of what time and dose they need to take their medication as well as what they have already taken. We intend for the results of the trial to be used as a starting point for the implementation of effective non-pharmacological adjuncts to pharmacological pain management after hemorrhoidectomies.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Matthew Rickard
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Address
93098
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Concord Repatriation General Hospital
Medical Centre, Level 1, Suite 102 Hospital Road, Concord NSW 2139
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Country
93098
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Australia
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Phone
93098
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+61 02 9767 7950
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Fax
93098
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+61 02 9767 6555
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Email
93098
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[email protected]
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Contact person for public queries
Name
93099
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Johnny Huang
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Address
93099
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Concord Repatriation General Hospital
Medical Centre, Level 1, Suite 102 Hospital Road, Concord NSW 2139
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Country
93099
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Australia
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Phone
93099
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+61425666830
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Fax
93099
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Email
93099
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[email protected]
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Contact person for scientific queries
Name
93100
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Johnny Huang
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Address
93100
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Concord Repatriation General Hospital
Medical Centre, Level 1, Suite 102 Hospital Road, Concord NSW 2139
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Country
93100
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Australia
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Phone
93100
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+61425666830
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Fax
93100
0
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Email
93100
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
To maintain patient confidentiality.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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