Does Persistent Pain Following a Motor Vehicle Crash Impact Functional Status in Older Adults?

Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study." This longitudinal inquiry enrolled 161 patients 65 years or older seeking care in an emergency department (ED) following a motor vehicle crash. Interviews were conducted at the initial ED visit and at 6 weeks, 6 months, and 1 year. Variables of interest were persistent pain, depressive symptoms, and interference with activities of daily living, with an end goal of impact on functionality. Study subjects with persistent pain at 6 months reported an overall decrease in their health status, and 23% needed additional assistance with their activities of daily living, resulting in a change in living arrangements compared with 8% of the subjects without persistent pain. Repeat ED visits in the 6 months following the crash were more likely to occur in those with persistent pain (30% vs. 15%). This study highlights the important role of the APN in providing quality care, communication about pain management, and related follow-up care.