Chronic pain management in the emergency department: A survey of attitudes and beliefs

Barth L. Wilsey, Scott M Fishman, Christine Ogden, Alexander Tsodikov, Klea D Bertakis

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective. The emergency department (ED) can be a particularly challenging environment in which to offer care for chronic pain. This study tried to determine if beliefs held by patients and providers about noncancer-related chronic pain affect evaluation and management of pain in ED. Intervention. We surveyed 103 patients presenting to the ED with chronic pain, 34 ED physicians, and 44 ED nurses to assess the influence of 15 possible barriers to managing chronic pain in the ED. Results. Patients were significantly more likely than providers to believe that their pain had to have a diagnosed physical component to be treated. Providers were significantly more likely than patients to believe that patients came to the ED because they lacked a primary care physician. All agreed that chronic pain treatment was not a priority in the ED and the potential for addiction, dependence, diversion, and forged prescriptions was low. Conclusions. Patients in chronic pain may need to be reassured that their pain will be treated, even in the absence of objective signs or magnified symptoms. Providers may wrongly believe that lack of a primary care physician brings these patients to the ED. Providers and patients appear to believe that treating chronic pain in the ED has a low priority. Both groups may underestimate the problems inherent with prescribing opioids in this setting.

Original languageEnglish (US)
Pages (from-to)1073-1080
Number of pages8
JournalPain Medicine
Volume9
Issue number8
DOIs
StatePublished - 2008

Fingerprint

Pain Management
Chronic Pain
Hospital Emergency Service
Primary Care Physicians
Surveys and Questionnaires
Pain
Opioid Analgesics
Prescriptions
Nurses
Physicians

Keywords

  • Addiction
  • Chronic Pain
  • Emergency Department
  • Opioid

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Chronic pain management in the emergency department : A survey of attitudes and beliefs. / Wilsey, Barth L.; Fishman, Scott M; Ogden, Christine; Tsodikov, Alexander; Bertakis, Klea D.

In: Pain Medicine, Vol. 9, No. 8, 2008, p. 1073-1080.

Research output: Contribution to journalArticle

Wilsey, Barth L. ; Fishman, Scott M ; Ogden, Christine ; Tsodikov, Alexander ; Bertakis, Klea D. / Chronic pain management in the emergency department : A survey of attitudes and beliefs. In: Pain Medicine. 2008 ; Vol. 9, No. 8. pp. 1073-1080.
@article{c0464db52d544e378c99ff4f93617e94,
title = "Chronic pain management in the emergency department: A survey of attitudes and beliefs",
abstract = "Objective. The emergency department (ED) can be a particularly challenging environment in which to offer care for chronic pain. This study tried to determine if beliefs held by patients and providers about noncancer-related chronic pain affect evaluation and management of pain in ED. Intervention. We surveyed 103 patients presenting to the ED with chronic pain, 34 ED physicians, and 44 ED nurses to assess the influence of 15 possible barriers to managing chronic pain in the ED. Results. Patients were significantly more likely than providers to believe that their pain had to have a diagnosed physical component to be treated. Providers were significantly more likely than patients to believe that patients came to the ED because they lacked a primary care physician. All agreed that chronic pain treatment was not a priority in the ED and the potential for addiction, dependence, diversion, and forged prescriptions was low. Conclusions. Patients in chronic pain may need to be reassured that their pain will be treated, even in the absence of objective signs or magnified symptoms. Providers may wrongly believe that lack of a primary care physician brings these patients to the ED. Providers and patients appear to believe that treating chronic pain in the ED has a low priority. Both groups may underestimate the problems inherent with prescribing opioids in this setting.",
keywords = "Addiction, Chronic Pain, Emergency Department, Opioid",
author = "Wilsey, {Barth L.} and Fishman, {Scott M} and Christine Ogden and Alexander Tsodikov and Bertakis, {Klea D}",
year = "2008",
doi = "10.1111/j.1526-4637.2007.00400.x",
language = "English (US)",
volume = "9",
pages = "1073--1080",
journal = "Pain Medicine",
issn = "1526-2375",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Chronic pain management in the emergency department

T2 - A survey of attitudes and beliefs

AU - Wilsey, Barth L.

AU - Fishman, Scott M

AU - Ogden, Christine

AU - Tsodikov, Alexander

AU - Bertakis, Klea D

PY - 2008

Y1 - 2008

N2 - Objective. The emergency department (ED) can be a particularly challenging environment in which to offer care for chronic pain. This study tried to determine if beliefs held by patients and providers about noncancer-related chronic pain affect evaluation and management of pain in ED. Intervention. We surveyed 103 patients presenting to the ED with chronic pain, 34 ED physicians, and 44 ED nurses to assess the influence of 15 possible barriers to managing chronic pain in the ED. Results. Patients were significantly more likely than providers to believe that their pain had to have a diagnosed physical component to be treated. Providers were significantly more likely than patients to believe that patients came to the ED because they lacked a primary care physician. All agreed that chronic pain treatment was not a priority in the ED and the potential for addiction, dependence, diversion, and forged prescriptions was low. Conclusions. Patients in chronic pain may need to be reassured that their pain will be treated, even in the absence of objective signs or magnified symptoms. Providers may wrongly believe that lack of a primary care physician brings these patients to the ED. Providers and patients appear to believe that treating chronic pain in the ED has a low priority. Both groups may underestimate the problems inherent with prescribing opioids in this setting.

AB - Objective. The emergency department (ED) can be a particularly challenging environment in which to offer care for chronic pain. This study tried to determine if beliefs held by patients and providers about noncancer-related chronic pain affect evaluation and management of pain in ED. Intervention. We surveyed 103 patients presenting to the ED with chronic pain, 34 ED physicians, and 44 ED nurses to assess the influence of 15 possible barriers to managing chronic pain in the ED. Results. Patients were significantly more likely than providers to believe that their pain had to have a diagnosed physical component to be treated. Providers were significantly more likely than patients to believe that patients came to the ED because they lacked a primary care physician. All agreed that chronic pain treatment was not a priority in the ED and the potential for addiction, dependence, diversion, and forged prescriptions was low. Conclusions. Patients in chronic pain may need to be reassured that their pain will be treated, even in the absence of objective signs or magnified symptoms. Providers may wrongly believe that lack of a primary care physician brings these patients to the ED. Providers and patients appear to believe that treating chronic pain in the ED has a low priority. Both groups may underestimate the problems inherent with prescribing opioids in this setting.

KW - Addiction

KW - Chronic Pain

KW - Emergency Department

KW - Opioid

UR - http://www.scopus.com/inward/record.url?scp=55749083772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=55749083772&partnerID=8YFLogxK

U2 - 10.1111/j.1526-4637.2007.00400.x

DO - 10.1111/j.1526-4637.2007.00400.x

M3 - Article

C2 - 18266810

AN - SCOPUS:55749083772

VL - 9

SP - 1073

EP - 1080

JO - Pain Medicine

JF - Pain Medicine

SN - 1526-2375

IS - 8

ER -