“…Because it may be days to weeks before patients receive care from other providers, emergency physicians have an important role in helping patients manage pain after ED visits [8]. Although there has been considerable research on pain management while patients are in EDs [6,9], much less attention has been paid to pain management after ED visits, despite several calls for this research [10][11][12][13][14][15].…”
Approximately one fifth of patients in the fracture and non-fracture groups did not receive an analgesic prescription. Age greater than 80 years and minority race/ethnic status were associated with lower rates of opioid prescribing.
“…Because it may be days to weeks before patients receive care from other providers, emergency physicians have an important role in helping patients manage pain after ED visits [8]. Although there has been considerable research on pain management while patients are in EDs [6,9], much less attention has been paid to pain management after ED visits, despite several calls for this research [10][11][12][13][14][15].…”
Approximately one fifth of patients in the fracture and non-fracture groups did not receive an analgesic prescription. Age greater than 80 years and minority race/ethnic status were associated with lower rates of opioid prescribing.
“…Yet analgesics are prescribed routinely in the ED without measuring the initial pain severity, beyond registering its presence. Similarly, effectiveness of analgesic therapies are not routinely verified prior to discharge, and assessment after discharge is almost unheard of 11,83 …”
“…Indeed, little information is available to quantify pain severity, patient improvement, and return to independent function after ED discharge. 27,28 Mobile-phone-based telemonitoring is described as an inexpensive and easy-to-organize method of postdischarge care in various medical populations and settings. 29,30 It is not surprising that this intervention was shown to improve adherence to analgesic treatment.…”
Section: Discussionmentioning
confidence: 99%
“…This is of particular interest because ED physicians rarely have the opportunity to follow-up trauma patients in the form of a scheduled visit. Indeed, little information is available to quantify pain severity, patient improvement, and return to independent function after ED discharge 27,28 . Mobile-phone–based telemonitoring is described as an inexpensive and easy-to-organize method of postdischarge care in various medical populations and settings 29,30 .…”
Objective:
To determine the impact of mobile-phone telemonitoring on patients’ adherence and satisfaction to post-trauma pain treatment.
Materials and Methods:
We conducted a prospective randomized clinical trial including patients with minor trauma discharged from the emergency department (ED) with analgesic treatment. Patients were randomized to one of three groups, control group where patients received a phone call on day-7, short message service (SMS) group where patients received a daily text message to remind them to take their treatment during 7 days and mobile-phone based telemonitoring (TLM) group. Patients’ adherence to analgesic treatments using the Morisky Medication Adherence Scale (MMAS-4), current pain by using a visual analogue scale (VAS) and patients’ satisfaction were assessed. For TLM group, assessment was performed at day-2, 4 and 7.
Results:
Good adherence was observed in 418 patients (92.9%) in TLM group versus 398 patients (88.6%) in SMS group and 380 patients (84.8%) in control group (P<0.001). The factor mostly associated with adherence was telemonitoring (OR 2.40 95% CI 1.55 to 3.71). The decrease of pain VAS was highest in TLM group compared to SMS and control groups (P<0.001). Percentage of patients’ satisfaction at 7-day post ED discharge was 93% in TLM group vs 88% in SMS group and 84% in standard group (P=0.02).
Discussion:
Our findings suggest that mobile-phone based telemonitoring is beneficial in the treatment of pain in trauma patients after ED discharge. This approach improved patients’ adherence and satisfaction.
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