Patient Education to Improve Pain Management in Older Adults With Acute Musculoskeletal Pain: A Pilot Randomized Trial

University of North Carolina, Chapel Hill75 enrolled

Overview

This is a three arm pilot randomized trial. Patients will be assigned to: 1. Usual care 2. Video education in the Emergency Department (ED) 3. Video education in the ED plus phone follow-up at three days with geriatric pain management specialist for all patients with pain \>=4/10

This is a three arm pilot randomized trial. Patients will be assigned to: 1. Usual care 2. Video education in the ED (10 minute interactive video) 3. Video education in the ED plus phone follow-up at three days with geriatric pain management specialist for all patients with pain \>=4/10

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Musculoskeletal Pain

Interventions

VideoBEHAVIORAL

This is a 10 minute interactive video which provided information to the viewer regarding the safe and effective use of analgesics for acute musculoskeletal pain at home. The focus is on acetaminophen, NSAIDs, and opioids.

Phone follow-upBEHAVIORAL

The call will be made by the study coordinator, who is a medical student. Any patients reporting a pain score in the past 24 hours of 4 or more will be re-contacted by an emergency physician with special training in geriatric pain management. This individual will provide recommendations to the patient regarding treatment options.

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 50 and older; ED visit for acute musculoskeletal pain Exclusion Criteria: * Cognitively impaired; chronic pain (daily opioid use prior to onset of pain or pain symptoms more than one month); prison; injury or pain condition requiring hospital admission.

Locations (1)

UNC Hospitals Emergency Department

Chapel Hill, North Carolina, United States

Outcomes

Primary Outcomes

Change in Pain Score

Change in Pain from emergency department (ED) visit to 30 day follow-up phone call will be measured by calculating the difference between the maximum pain score in the ED and the patient reported average overall pain severity in the past week using the 0-10 numeric rating scale for both measures.Change in pain will be reported as a negative number if the pain decreases (i.e., 10 to 8 = -2). Higher scores indicate a worse outcome.

Time frame: ED visit and 30 days post-ED visit

Secondary Outcomes

Number of Participants Experiencing Medication Side Effects

Patients were asked if they experienced any of the following side effects: fatigue, drowsiness, trouble sleeping, trouble thinking, dizziness, unsteadiness, nausea, vomiting, constipation, abdominal pain, black or bloody stool, trouble urinating, loss of appetite, itching or shortness of breath. Patients were also queried about any other side effects they had that were not on the list. Participants reporting at least one side effect were included.

Time frame: 30 days after ED visit

Average Overall Pain at One Month

Determined using 0-10 numerical rating scale to answer the question "What is the average amount of pain you have experienced over the last week on a scale of 0-10. where 0 means no pain and 10 means pain as severe as it could possibly be.

Time frame: 30 days after ED visit

Mean Physical Function Scores

Using a measure of higher-level physical function based on walking, climbing stairs, and carrying bags - scores range from 0 to 12 with higher score indicating higher function.

Time frame: 30 days after ED visit

Data from ClinicalTrials.gov

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