Patient-centered care for chronic pain in the emergency department: A qualitative study

Pain is a common problem for which patients seek care in the emergency department, accounting for up to 42% of all ED visits. The purpose of this study was to explore qualitatively the reasons for use of the emergency department (ED) by those frequenting the ED for treatment of chronic pain. The settings for the study were two sites of a large U.S. Midwestern healthcare system. The sample comprised patients who used the ED four or more times in the 3-month time of data collection. From a total of 85 frequent users identified through retrospective chart reviews, a computer generated random sample of patients was selected to explore their reasons for use of ED for treatment of chronic pain. Content analysis was used to identify themes from the interviews. Four themes emerged from the qualitative data analysis: time of day, pain intensity, barriers to and reasons for using the emergency department for care, and lack of individualized plan of care. Reasons patients use the ED for chronic pain are numerous and complex. Leaders of healthcare organizations must address patient-centered care, with specific alternatives to the emergency department such as individualized care plans, and care transition interventions.