Association between pain control and patient satisfaction outcomes in the emergency department setting

Brown, Tristam; Shetty, Amith; Zhao, Dong; Harvey, Nathan; Yu, Teresa; Murphy, Margaret

doi:10.1111/1742-6723.12945

Cited by 24 publications

(13 citation statements)

References 26 publications

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“…Poor pain control is still one of the most frequently cited reasons for lack of patient satisfaction with ED care, and a common reason for poor post-ED discharge outcomes. 13 Medication side effects are an additional major patient complaint. 12 Accordingly, patient-centered care in EDs would benefit from systems to support pharmacogenetically guided treatment to improve treatment efficacy, medication tolerability, and patient-oriented outcomes.…”

Section: Discussionmentioning

confidence: 99%

United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

Manandhar

Erkanli

Eucker

et al. 2021

WestJEM

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Introduction: Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied. Methods: We conducted a cross-sectional analysis of the 2010–2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). We reported the proportion of ED visits in which at least one medication with Clinical Pharmacogenetics Implementation Consortium (CPIC) recommendation of Level A or B evidence was ordered. Secondary comparisons included distributions and 95% confidence intervals of age, gender, race/ethnicity, ED disposition, geographical region, immediacy, and insurance status between all ED visits and those involving a CPIC medication. Results: From 165,155 entries representing 805,726,000 US ED visits in the 2010–2015 NHAMCS, 148,243,000 ED visits (18.4%) led to orders of CPIC medications. The most common CPIC medication was tramadol (6.3%). Visits involving CPIC medications had higher proportions of patients who were female, had private insurance and self-pay, and were discharged from the ED. They also involved lower proportions of patients with Medicare and Medicaid. Conclusion: Almost one fifth of US ED visits involve a medication with a pharmacogenetic recommendation that may impact the efficacy and toxicity for individual patients. While direct application of genotyping is still in development, it is important for emergency care providers to understand and support this technology given its potential to improve individualized, patient- centered care.

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Section: Discussionmentioning

confidence: 99%

United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

Manandhar

Erkanli

Eucker

et al. 2021

WestJEM

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“…These tools are of primary importance to both patients and physicians in objectifying levels of pain. Studies show that improvement in pain scores are directly correlated with patient satisfaction which can significantly influence the clinical course of patients experiencing an episode of acute pain [40]. Although it is well established that PCADs reduce pain scores in the post-operative setting there has been some controversy as to whether this would hold true for ED patients, as they often do not have as much time to convalesce from injuries.…”

Section: Pain Reductionmentioning

confidence: 99%

The Utility of Patient-Controlled Analgesia for Managing Acute Pain in the Emergency Department

Bender¹,

Papa²

2019

From Conventional to Innovative Approaches for Pain Treatment

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There is a growing expectation of physicians to treat acute pain more aggressively in the emergency department (ED). This has contributed to an increase in opiate prescribing practices that has resulted in a crisis of medication abuse and misuse. The resultant backlash against physicians has created a void within the realm of acute pain management, as physicians search for a means to treat their patients in a way that is both empathetic and responsible. In an effort to combat this growing epidemic, alternative means of pain control are being explored. Patientcontrolled analgesia devices (PCADs) have been used extensively in multiple fields of medicine and have demonstrated significant clinical utility for treating pain postoperatively; however there is a dearth of evidence to support their use within the acute care setting. Due to this lack of evidence, PCADs have not been widely implemented in the ED. Recent studies have shown that the use of PCADs may improve objective pain scores and increase both patient and nurse satisfaction while reducing the likelihood of developing chronic pain. The economic feasibility of this undertaking remains unclear; however there is strong evidence for the clinical utility of this modality to treat acute pain in this population.

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“…However, pain management in pre-hospital settings or in the ED is unsatisfactory [2,3]. Studies have documented that effective trauma pain management is very important for enhancing patient therapeutic compliance, quality of life, and satisfactory outcomes, which leads to shorter hospital stays [4,5]. Traditional pharmacotherapeutic options for acute pain in trauma settings include different kinds of opioid and non-opioid drugs (e.g., morphine, nitrous oxide, non-steroidal anti-inflammatory drugs) [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Does Inhaled Methoxyflurane Implement Fast and Efficient Pain Management in Trauma Patients? A Systematic Review and Meta-Analysis

Liu

Ren

et al. 2021

Pain Ther

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Association between pain control and patient satisfaction outcomes in the emergency department setting

Cited by 24 publications

References 26 publications

United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

United States Emergency Department Use of Medications with Pharmacogenetic Recommendations

The Utility of Patient-Controlled Analgesia for Managing Acute Pain in the Emergency Department

Does Inhaled Methoxyflurane Implement Fast and Efficient Pain Management in Trauma Patients? A Systematic Review and Meta-Analysis

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