IDENTIFYING THE RELATIONSHIP BETWEEN PATIENT REPORTED OUTCOMES AND TREATMENT WITH OPIATES IN THE EMERGENCY DEPARTMENT

Abstract

Background and aim: Pain is considered the most common reason to present to the emergency department (ED). The overall increase of harms from opioid misuse and increases in mortality from opioid overdose may affect the use of prescribed opioids to treat pain in the ED. There is a paucity of literature to investigate patient reported outcomes (PROs) and demonstrate the relationship between opioid use in the ED and PROs. Literature demonstrates that opioid use in the ED can enhance the PROs, but further details at this time are unknown. This study aims to investigate the difference in PROs between patients who received opiate analgesics and those who did not by application of symptoms management theory (SMT) to investigate factors that may influence PROs of acute pain care in the ED. Method: This is a retrospective study using secondary data collected for another purpose by Hughes et al. (2020), which aimed to evaluate the application of Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) of acute pain care received in the ED. This study used questions from Patient Experience of Pain in the Emergency Department (PEPED) questionnaire in addition to APS-POQ-R tool. Data were analysed by using descriptive analysis, bivariate analysis, and multivariate modelling to identify the relationship between PROs and treatment with opioid in the ED when controlling of other factors. Results of each analysis will be presented separately and will be discussed in more detail in result and discussion sections. Result: The total sample was 200 patients divided into patients who received opiates in the ED (n=170) and those who did not (n=70). In multivariate modelling, opioid administration is not significantly related to the overall PROs. However, receiving an opioid is significantly associated with the patient perception of acute pain care in the ED. Patients presenting with ongoing conditions or concern and being admitted to the hospital after ED pain care are factors associated with report of poor pain care in the ED. Conclusion: This study examined the relationship between PROs and treatment of acute pain with opiates in the ED. There is no relationship between PROs and treatment with opiates for acute pain care in the ED. However, there is an association between perception of ED pain care and opioid administration for acute pain care in the ED.