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Pediatric self-reported pain outcomes via texting following emergency department discharge: How does it compare to
Keli D Coleman1, Michael Webb2, Bradley J Barney2,3
1Department of Pediatrics, Medical College of Wisconsin and the Children's Research Institute of Children's Wisconsin, Section of Emergency Medicine, Milwaukee, WI, USA.
Insights
Children aged 8-17 can effectively report pain after emergency department (ED) discharge via text message, comparable to parents. Their reports indicate higher pain severity and medication dissatisfaction, highlighting the value of direct child reporting for acute pain management.
Area of Science:
- Pediatric Emergency Medicine
- Pain Management
- Digital Health
Background:
- Accurate assessment of pediatric pain after emergency department (ED) discharge is crucial for effective management.
- Text messaging offers a promising method for collecting patient-reported outcomes, but its utility in pediatric populations requires further investigation.
Purpose of the Study:
- To compare child and parent text message reporting of pain outcomes in children discharged from the ED with a long-bone fracture.
- To evaluate the feasibility and concordance of text-based pain reporting between children (8-17 years) and their parents.
Main Methods:
- A single-center study enrolled 80 child-parent dyads where children had long-bone fractures and were discharged from the ED.
- Both children and parents reported daily on pain-related dysfunction, maximum pain, and medication dissatisfaction via text message for 7 days.
- Paired t-tests and mixed models were used to analyze differences in reported outcomes, and text response rates were assessed.
Main Results:
- Children's text reporting rates were comparable to parents, with 80% of children reporting for at least one day.
- Children reported similar levels of pain-related dysfunction compared to parents (P=0.086).
- Children reported significantly higher maximum pain scores (P=0.006) and medication dissatisfaction (P<0.001) than their parents.
Conclusions:
- Children aged 8-17 can reliably report their acute pain experiences via text message post-ED discharge.
- Direct child reporting provides valuable insights into pain severity and treatment satisfaction, complementing parental reports.
- Text messaging is a feasible and effective tool for capturing pediatric pain outcomes in the at-home setting.
Objectives:
Compare child and parent text message reporting of pain outcomes following emergency department (ED) discharge.
Methods:
Children 8 to 17 years, discharged from the ED with long-bone fracture, whose parent was enrolled in the multicenter study to report their child's pain and function outcomes (R01HD091302) were enrolled in this single-center study between April 2021 and February 2022. Both respondents reported pain-related dysfunction (scale: 0 to 10), maximum pain (scale: 0 to 10), and medication dissatisfaction (scale: 1 to 4) for 7 days by text message. Average differences in outcomes between respondents were tested using a paired t-test and mixed models. Text response rate was evaluated.
Results:
Overall, 80 child-parent dyads were included, and 80% of children texted reports on at least 1 day, 74% for ≥3 days, and 45% for all 7 days. Parents' overall response rate was 91% for at least 1 day, 80% for ≥3 days, and 44% for all 7 days. Compared to parents, child reports were not different for the child's dysfunction score (difference = 0.21 points, 95% CI: -0.03, 0.44; P-value = 0.086) but were higher for child's maximum pain score (0.31 points, 95% CI: 0.09, 0.52; P-value = 0.006) and dissatisfaction score (0.22, 95% CI: 0.15, 0.30; P-value = <0.001).
Discussion:
Children ages 8 to 17 years can report at-home pain experiences by text message at rates comparable to their parents. Children report significantly higher pain severity and dissatisfaction with pain medications, but dysfunction was similar compared to parent's report. Children and their parents can text message their at-home acute pain experiences after ED discharge.
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