Pain after discharge: A pilot study of factors associated with pain management and functional status

Little is known about how continued pain after discharge from the emergency department is managed by patients, and how it may interfere with the functional status of patients. The purpose of this pilot study was to evaluate pain management practices, patient satisfaction with pain medications, and how continued pain after ED discharge may influence the functional status of patients who presented with chief complaints of abdominal, chronic, abscess, or trauma-related pain.

This prospective, descriptive study was conducted at 2 Level 1 trauma hospitals. Twenty-nine patients completed an emergency department discharge questionnaire and follow-up phone survey. Data were collected via telephone interviews an average of 72 hours after discharge.

On emergency department discharge, patients reported pain intensity that had not decreased significantly at the time of the home interview. Most patients (78%) used ED-prescribed medications and reported a high level of satisfaction with their pain relief (7.2 +/- 2.1). Continued pain after ED discharge primarily interfered with patient's ability to work (7.3 +/- 3.8), to go outside for social activities (6.5 +/- 4.1) and to ambulate (5.0 +/- 4.1).

Patients in this study, on average, continued to experience pain for up to 96 hours after discharge from the emergency department. They reported a high level of pain relief from their ED-prescribed medications. However, interference with functions of daily living due to continued pain was substantial. Further studies are needed to examine the paradoxical reports of high satisfaction with pain relief yet substantial functional limitations experienced by patients after ED discharge.