Investigating discharged ED patients' pain management experience

79% of ED patients present with pain, yet little is known regarding how unresolved pain affects patients' functional status.

This prospective, descriptive, 7-day pilot-study investigated how unrelieved pain affects functional status. Participants self-entered demographic data at ED discharge while research-team members collected triage scores, pain intensity scores, pain treatments, pain reassessments, discharge pain intensities, and prescriptions. Seven-day pain diaries were completed. At follow-up participants completed four PROMIS questionnaires.

We approached 96 patients at ED discharge enrolling 25 (26%); 12 (48%) completed the entire study; 64% were female, 19-66 years (38.12 ± 14.23). Pain intensity at discharge was 7.25 ± 1.3 (4-10). Pain intensity 24 hours after discharge was 5.71 ± 3.12 and 7 days later was 2.50 ± 1.35. Participants rated their health (1 = poor, 5 = excellent) as good (3.33 ± 0.99), and reported moderate fatigue (2.83 ± 0.58) (1 = none, 5 = very severe). T-Scores for Pain Behavior (60.5 ± 2.8), Pain Interference (66.6 ± 6.0), and Sleep Disturbance (56.5 ± 10.0) were worse than the general public.

Patients are discharged with unrelieved pain affecting their lives. Research investigating pain assessment and treatment along with detailing patients' daily pain intensity and satisfaction, self-management of pain, and functional status is warranted. Demonstrating these relationships may lead to interventions designed to quickly alleviate decreased functional status so patients may return to their previous health status.