Pain Care Management in the Emergency Department: A Retrospective Study to Examine One Program's Effectiveness

The Characteristics and Effectiveness of Interventions for Frequent Emergency Department Utilizing Patients With Chronic Noncancer Pain: A Systematic Review

“…Each of the studies that measured the frequency of ED visits (n = 12) reported a decrease in the number of visits following the implementation of an intervention. [19][20][21][22][23][24][25][26][28][29][30][31] Nine of the studies reported statistically significant reductions in the frequency of ED visits (from p < 0.0001 to p < 0.05), 19,22,23,[26][27][28][29][30][31] one reported a nonsignificant reduction (p = 0.68), 21 and two studies did not report a p value. 19,24 • Patients referred to taper-to-abstinence pain management clinic run by a pain management and addiction specialist;…”

“…As detailed in Table 1, a total of four RCTs [19][20][21][22] and nine noncontrolled before-after studies (NCBAS) [23][24][25][26][27][28][29][30][31] were included, involving the assessment of 609 patients and 1,070 patients, respectively (total N = 1,679). The sample sizes of the RCTs ranged from 40 to 406 patients while the sample sizes for the NCBAS were slightly smaller ranging from 14 to 314.…”

“…Eight of the included studies implemented multifaceted interventions that included two or more of the identified components, 19,20,[22][23][24][25][26]30 and the remaining five studies implemented interventions that were focused around a singular component. 21,[27][28][29]31 Study Quality Assessment Four randomized studies were assessed using the Cochrane RoB 2.0 tool and nine nonrandomized studies were assessed using the ROBINS-I tool.…”

“…In nine of the 13 included studies we identified a high risk of bias due to confounding given the lack of a formal control group or a lack of procedures to control at the analysis stage. [23][24][25][26][27][28][29][30][31] We identified a high risk of bias due to participant selection in three of the 13 studies. [23][24][25] These concerns were most pronounced in the retrospective studies that participant selection for analyses occurred after the intervention had been implemented.…”

Safe Management of Chronic Pain in Pregnancy in an Era of Opioid Misuse and Abuse

“…They recommend a periodic review of the management plan, though there is no specific suggested interval. The pain treatment modality selected needs to be communicated to everyone involved in the care of the pregnant woman, and in particular the patient's primary care provider (PCP), to prevent overprescribing and misuse of controlled substances (ACOG, ; Masterson & Wilson, ).…”