Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Effectiveness of Electronic Integrated Marketing Communications on Customer Purchase Intention of Mobile Service Providers: the Mediating Role of Customer Trust.

This study examines the impact of electronic integrated marketing communication (E-IMC) on customer buying intention. Furthermore, it explores the mediation effect of customer trust in the relationship between E-IMC and customer purchase intention. Empirical evidence was obtained from 277 mobile phone users in Palestine, and structural equation modeling applied. The findings of this study revealed that E-IMC positively impacts purchase intention. Further, each of E-IMC dimensions (online advertising, online sales promotion, and online relationship marketing) were also a significant predictor of purchase intention. The findings also revealed that the positive relationship between E-IMC and purchase intention is mediated by customer trust. We conclude with a theoretical contribution, managerial implications, limitations, and suggestions for future studies

Linking Social Media Marketing Activities to Revisit Intention through Brand Trust and Brand Loyalty on the Coffee Shop Facebook Pages: Exploring Sequential Mediation Mechanism

Social media marketing (SMM) is a new field that involves the marketing of goods, services, information, and ideas via online networks and social media. Drawing on the stimulus-organism-response framework, this study aims to examine how social-media-marketing activities (SMMA) affect brand loyalty, brand trust, and revisit intention (returning to the same place in the future) for coffee shops in Northern Cyprus. Empirical evidence was collected from 415 undergraduate students who follow specific coffee shops on Facebook, and a structural equation modeling approach was applied. The results showed a significant positive influence of SMMA on brand loyalty, brand trust, and revisit intention. The findings show that SMMA are a stronger predictor of revisit intention than brand loyalty and brand trust. Furthermore, brand loyalty and brand trust are significant mediators in the relationship between SMMA and revisit intention. Additionally, the sequential mediation effects of brand loyalty and brand trust in the relationship between SMMA and revisit intention are supported. Overall, with effective SMMA from coffee shops on Facebook, the customer grows confidence in the brand, which increases the level of brand loyalty. This, in turn, encourages revisit intention of the customer. As a result, brand executives on social media platforms (in this case, Facebook) should promote specific SMMA for their brands and engage in such activities to creates brand trust and brand loyalty. These findings contribute to the literature by examining the relationship between SMMA and revisit intention and exploring how SMMA affect revisit intention by adding brand loyalty and brand trust as mediators

Power Brand Defense Up, My Friend! Stimulating Brand Defense through Digital Content Marketing

Digital content marketing that increases consumers’ favorable behavior is of increasing interest to marketers. However, there is a lack of studies that examine the relative effect of digital content marketing on brand defense. Building on the theoretical lens of elaboration likelihood model, attachment theory, and source credibility theory, this experimental study examines the relative effect of two types of digital content marketing on brand defense, taking into consideration the mediation effect of behavioral engagement and the moderation effect of age generation. Based on 237 participants collected from a United States sample, the findings of this study revealed that user-generated content is a stronger predictor of brand defense and behavioral engagement compared to firm-generated content. Further, behavioral engagement served as a mediator variable between the digital content marketing types and brand defense. Significant evidence has additionally been found between behavioral engagement and brand defense. Moreover, the findings of the moderation analysis illustrated that Generation Z is the most influenced by user-generated content, followed by Generations X and Y. Generation Y is the most influenced by firm-generated content, followed by Generations Z and X. This study adds empirical relevance to the growing literature of the importance of digital content marketing, behavioral engagement, and generation as well validates the effects of those constructs on brand defense