Chronic pain in the ED

Bernard, Aline M.; Wright, Seth W.

doi:10.1016/j.ajem.2004.07.026

Cited by 33 publications

(39 citation statements)

References 17 publications

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“…Multiple investigations reveal that the ED is not the appropriate treatment area for chronic pain . Patients who present to the ED for chronic pain contribute to the increasing cost of healthcare and ED overcrowding with issues that are best treated elsewhere given the complexity of the physical and psychosocial components of these patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Chronic Pain Protocol on Emergency Department Utilization

Olsen¹,

Ogarek

Goldenberg

et al. 2016

Academic Emergency Medicine

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Objectives: Patients suffering from chronic painful conditions frequently present to the emergency department (ED) for pain control. In an effort to better manage these patients we implemented and measured the effect of enrollment in a chronic pain protocol in a single ED.Methods: A retrospective (pre) and prospective (post) study design was utilized. We identified 46 frequent ED users suffering from chronic painful conditions. We then retrospectively documented their ED use and prescription controlled substance use for 6 months prior to enrollment in a chronic pain protocol and then 6 months postenrollment.Results: Preenrollment participating patients visited the ED on average 6.2 times in a 6-month period. Postenrollment their mean number of visits in the following 6 months decreased significantly to 2.2 times, or a 65% decrease (p < 0.001). Similarly, preenrollment, the patients were prescribed a median of 664 controlled substance pills in the entire state compared to 471 pills in the 6-month period postenrollment, or a 29% decrease (p < 0.022).Conclusions: Through instituting a chronic pain protocol, we found significant reductions in the number of return visits to a single ED and the number of controlled substance medications prescribed by all providers. Additional studies using similar protocols could help establish their impact on the care of patients suffering from chronic pain and the potential to reduce healthcare costs, ED overcrowding, and prescription drug abuse.ACADEMIC EMERGENCY MEDICINE 2016;23:424-432

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Section: Discussionmentioning

confidence: 99%

Impact of a Chronic Pain Protocol on Emergency Department Utilization

Olsen¹,

Ogarek

Goldenberg

et al. 2016

Academic Emergency Medicine

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“…Living in pain though is not a normal human experience and a powerful motivating force to seek help (Bernard and Wright, 2004;Louw, Louw, and Crous, 2009;Mortimer et al, 2003). One treatment strategy aimed at helping ease pain and often the associated suffering and disability is patient education (Brox et al, 2008;Engers et al, 2008;Heymans et al, 2005;Liddle, Gracey, and Baxter, 2007).…”

Section: Introductionmentioning

confidence: 95%

The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature

Louw

Zimney

Puentedura

et al. 2016

Physiotherapy Theory and Practice

544

395

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“…Chronic pain accounts for 10–16% of emergency department (ED) visits [5, 6] with some patients relying heavily on emergency resources [7, 8]. The ED is not considered an appropriate setting for treating chronic pain [5, 7, 9, 10] and it is well established that many ED visits for chronic diseases are preventable [11].…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations

Poulin

Nelli

Tremblay

et al. 2016

Pain Research and Management

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Background. Chronic pain (CP) accounts for 10–16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives. To describe patients with CP attending the ED and identify factors contributing to their visit. Methods. We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem. Results. Fifty-eight patients (66% women; mean age 46.5, SD = 16.9) completed the study. The most frequently cited reason (60%) for ED visits was inability to cope with pain. Mental health problems were common, including depression (61%) and anxiety (45%). Participants had questions about the etiology of their pain, concerns about severe pain-related impairment, and problems with medication renewals or efficacy and sometimes felt invalidated in the ED. Although most participants had a primary care physician, the ED was seen as the only or best option when pain became unmanageable. Conclusions. Patients with CP visiting the ED often present with complex difficulties that cannot be addressed in the ED. Better access to interdisciplinary pain treatment is needed to reduce the burden of CP on the ED.

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Chronic pain in the ED

Cited by 33 publications

References 17 publications

Impact of a Chronic Pain Protocol on Emergency Department Utilization

Impact of a Chronic Pain Protocol on Emergency Department Utilization

The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature

Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations

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