Opioid Use and Predicting Factors at the Emergency Department

Radboud University Medical Center149 enrolled

Overview

Background: Increasing opioid misuse is a worldwide problem. About 10% of opioid misusers are primarily exposed to opioids at the Emergency Department (ED). This study was conducted to determine the feasibility for a clinical trial investigating the effect of Virtual Reality therapy on opioid consumption at the ED. Methods: Adult patients were included when primarily seen by the Emergency Physician and presenting with a NRS pain score ≥4. Main objective was to identify the target population and evaluate outcome measures to sustain a trial incorporating the Oral Morphine Equivalent (OME) at the ED as the primary endpoint. Primary outcome was mean OME administered at the ED. Secondary outcomes included NRS pain scores, main symptoms and type of analgesics administered at the ED.

Study Type

OBSERVATIONAL

Enrollment

149

Conditions

Pain Pain, Acute

Interventions

Usual careOTHER

Patients received usual care

Sex: ALLMin age: 16 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient ≥16 years admitted to ED and identified by an Emergency Physician (EP) * NRS pain score ≥4 * Patient is willing and able to comply with the study protocol Exclusion Criteria: * Patients initially treated by another physician than the EP. * EMV \< 14 * History of dementia, seizures * Severe hearing/visual impairment not corrected * Headwounds or damaged skin with which comfortable and hygienic use is not possible. * Presentation to ED because of chronic pain (≥3 months) exacerbation * Chronic opioids use (≥3 months)

Locations (1)

Radboud university medical center

Nijmegen, Gelderland, Netherlands

Outcomes

Primary Outcomes

Opioid use

Opioids use of patients during their stay at Emergency Department (yes/no)

Time frame: throughout study participation, up to 8 hours

Secondary Outcomes

Oral morphine equivalent

Doses of opioids received by a patient during their stay at the ED converted to Oral morphine equivalent (OME)

Time frame: throughout study participation, up to 8 hours

Administered analgesics

Type and dose of all administered analgesics at Emergency Department.

Time frame: throughout study participation, up to 8 hours

Pain acceptability

Patient opinion on acceptability of their pain at rest upon admittance and discharge

Time frame: Asked at moment of admittance and at discharge, up to 6 hours after inclusion

Reason why patients finds pain acceptable

Open question

Time frame: Assessed upon admittance

Patients desire for analgesics

yes/no question whether patient desires analgesics

Time frame: Asked at moment of admittance and at discharge, up to 6 hours after inclusion

Patients openness to VR

yes/no question to explore patients willingeness to use VR in their situation

Time frame: Assessed upon admittance

Numaric rating score pain scores at rest

Including whether this is pre/post analgesics

Time frame: Every 30 minutes until discharge of patient

Numaric rating score anxiety scores

NRS anxiety scores

Time frame: Every 30 minutes until discharge of patient

Satisfaction with pain management

On a numaric rating scale

Time frame: Asked at moment of discharge, up to 6 hours after inclusion

Nurse opinion on patient adequacy of pain reporting

Categorical question: understating - adequate - exaggerating

Time frame: Assessed upon admittance

Duration of ED visit

Time frame: throughout study participation, up to 8 hours

Analgesics prescriptions

When patient is discharged home prescribed analgesics are registered.

Time frame: throughout study participation, up to 8 hours

Data from ClinicalTrials.gov

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Opioid Use and Predicting Factors at the Emergency Department

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes