ER Patients Need to Know More about Pain Management

By Jane Farrell

Patients in the emergency room want to know more about the possibilities for pain management than their doctors are telling them. They also want to know about the risk of opioid dependency.

The study, by researchers from the Perelman School of Medicine at the University of Pennsylvania, used semi-structured open-ended telephone interviews with 23 patients (mostly women, ages 18 to 65) discharged from the Hospital of the University of Pennsylvania after being seen in the emergency department. The reasons for the visits included broken arms or legs as well as kidney stones and back injury.

“It was interesting to find that patients believe that taking an opioid as prescribed prevents the possibility of addiction, but also that patients are learning about opioids from television and from friends and acquaintances — not healthcare providers,” said senior author Zachary F. Meisel, MD, MPH, MS, assistant professor and attending physician in the department of Emergency Medicine, who oversaw the study led by Robert J. Smith, BS, a medical student at Penn. “There’s clearly a significant need for emergency departments to improve education around the risks of opioid misuse.”

Patients said they wanted to take part in decisions about their treatment plan, more consideration of how the pain affects their life, and more “emphathy” from providers. They said they felt that  fragmentation” in communication between providers themselves was detrimental.

“Patients realize that emergency departments are busy places, but that doesn’t reduce their desire to have meaningful interactions with their care providers,” said Meisel. “Patients want to be given information in a straight-forward way and then listened to, so that they leave feeling like they know what was causing their pain, what their pain management options were, and that their treatment preferences were heard.”

The findings were published in the Annals of Emergency Medicine.

The researchers are now focusing on short video narratives to improvement a patient’s understanding of their pain-management options and the risk of opioid misuse.