Understanding the Impact of Chronic Pain in the Emergency Department: Prevalence and Characteristics of Patients Visiting the Emergency Department for Chronic Pain at an Urban Academic Health Sciences Centre

被引:9
作者
Small, Rebecca N. [1 ,2 ]
Shergill, Yaadwinder [2 ,3 ]
Tremblay, Steve [4 ,5 ]
Nelli, Jennifer [6 ]
Rice, Danielle [2 ,7 ]
Smyth, Catherine [2 ,4 ,5 ]
Poulin, Patricia A. [2 ,4 ,8 ]
机构
[1] Mem Univ Newfoundland, Fac Med, St John, NF, Canada
[2] Ottawa Hosp, Res Inst, Ottawa, ON, Canada
[3] Ctr Collaborat Hlth, Oakville, ON, Canada
[4] Univ Ottawa, Dept Anesthesiol & Pain Med, Ottawa, ON, Canada
[5] Ottawa Hosp, Dept Anesthesiol & Pain Med, Ottawa, ON, Canada
[6] Hamilton Hlth Sci Ctr, Dept Anesthesiol, Hamilton, ON, Canada
[7] McGill Univ, Dept Psychol, Montreal, PQ, Canada
[8] Ottawa Hosp, Dept Psychol, Ottawa, ON, Canada
来源
CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR | 2019年 / 3卷 / 01期
关键词
Chronic pain; emergency department; prevalence; opioids; mental health;
D O I
10.1080/24740527.2019.1587290
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Canadians make approximately 16 million visits to the emergency department (ED) each year. ED visits for non-urgent reasons contribute to suboptimal patient care and ineffective resource use. Aims To estimate the proportion of ED visits related to chronic pain at our institution. Methods. We conducted a retrospective review of 1000 randomly selected ED visits at TOH during the 2012-2013 fiscal year (April 1, 2012 to March 31, 2013). Visits for chronic pain were identified using pre-defined criteria. Demographic and medical data were extracted from medical charts. Results 104 visits during this time period were related to chronic pain (10.4%; 95% CI: 8.2-12.6). All visits were from unique patients (i.e., no patients contributed more than 1 visit). Patients were predominantly women (71%), with a mean age of 45.9 years. Seventy-eight percent of patients had a primary care provider. The most common location of pain included the abdomen (24%), the head or face (21%), and the low back (21%). Only 5% of patients had consultation with a pain medicine specialist while 78% were awaiting a consultation. More than 2/3 of patients (71%) reported using opioids for their pain. Conclusion Presenting to the ED for chronic pain was found to occur among a sample of ED visits reviewed. This can result in ineffective care for patients with chronic pain. Cost-effective solutions to improve clinical outcomes and reduce ED use for chronic pain may yield significant improvements in health outcomes of patients and benefits for the health care system. RESUME Contexte: Les Canadiens font approximativement 16 millions de visites aux urgences chaque annee. Les visites aux urgences pour des raisons non urgentes contribuent a ce que les soins aux patients soient sous-optimaux et que les ressources soient utilisees de maniere inefficace. Objectifs: Estimer la proportion de visites aux urgences liees a la douleur chronique a notre institution. Methodes: Nous avons fait un examen retrospectif de 1 000 visites aux urgences de l'Hopital d'Ottawa selectionnees de maniere aleatoire qui avaient eu lieu au cours de l'exercice financier 2012-2013 (1(er) avril 2012 au 31 mars 2013). Les visites en raison d'une douleur chronique ont ete reperees a l'aide de criteres predefinis. Les donnees demographiques et medicales ont ete extraites des dossiers medicaux. Resultats: Au cours de la periode a l'etude, 104 visites etaient liees a la douleur chronique (10,4 %; IC 95% : 8,2 - 12,6). Toutes les visites etaient le fait de patients uniques (i.e. aucun patient n'a contribue pour plus d'une visite). Les patients etaient en majeure partie des femmes (71 %), dont l'age moyen etait de 45,9 ans. Soixante-dix huit pour cent des patients avaient un prestataire de soins primaires. L'endroit oU la douleur se manifestait le plus frequemment etait l'abdomen (24 %), la tete ou le visage (21 %) et le bas du dos (21 %). Seulement 5 % des patients avaient consulte un medecin specialiste de la douleur tandis que 78 % etaient en attente d'une consultation. Plus de 2/3 des patients (71 %) ont declare avoir utilise des opioides pour leur douleur. Conclusion: Il a ete constate que parmi l'echantillon de visites a l'etude, des patients s'etaient presentes aux urgences en raison d'une douleur chronique. Cette situation peut avoir pour consequence que les soins prodigues aux patients souffrant de douleur chronique soient inefficaces. La mise en place de solutions efficientes pour ameliorer les resultats cliniques et diminuer le recours aux urgences pour de la douleur chronique pourrait grandement ameliorer les resultats de sante des patients tout en etant avantageux pour le systeme de sante.
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收藏
页码:106 / 113
页数:8
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