The effect of provision of pain management advice on patient satisfaction with their pain management: a pilot, randomised, controlled trial (pain advice trial)

Abstract

Objective We aimed to provide pain advice ('The treatment of pain is very important and be sure to tell the staff when you have pain') as an intervention and evaluate its effect upon patient satisfaction. The purpose of this pilot trial was to ensure the design and methods of a future trial are sound, practicable and feasible. Method We undertook a pilot, randomised, controlled, clinical intervention trial in a single ED. The control arm received standard care. The intervention arm received standard care plus pain advice from an independent investigator. All patients and treating ED staff were blinded to patient enrolment. Patient satisfaction with their pain management (six-point ordinal scale) was measured 48 h post-ED discharge, by a blinded researcher. The primary outcome was satisfaction with pain management. Results Of the 280 and 275 patients randomised to the control and intervention arms, respectively, 196 and 215 had complete data, respectively. 77.6% (152/196) and 88.8% (191/215) of patients reported being provided with pain advice, respectively (difference 11.3% (95% CI 3.6 to 19.0)). The intervention was associated with absolute and relative increases in patient satisfaction of 6.3% and 14.2%, respectively. 91.3% (179/196) and 76.3% (164/215) of patients who were/ were not very satisfied reported having received 'pain advice' (difference 15.0% (95% CI 7.6 to 22.5)). Conclusions The intervention to provide pain advice resulted in a non-significant increase in patient satisfaction. A larger multicentre trial is feasible and is recommended to further explore the effects of provision of pain advice. Trial registration number ACTRN12615000097549.

Analgesia in the emergency department: why is it not administered?

“…The secondary outcome was patient satisfaction with their pain management, specifically the proportion of patients who were ‘very satisfied’ 18. This level of satisfaction was chosen as the primary outcome as it is a patient-centred target for the ED staff.…”

“…Approximately 48% of patients treated in our ED are ‘very satisfied’ with their pain management 18. We hypothesised that more patients who receive analgesia would be ‘very satisfied’ than patients who do not and that a clinically significant difference in the proportions who are ‘very satisfied’ is 15%, for example, 50% vs 35%, respectively.…”

“…We hypothesised that more patients who receive analgesia would be ‘very satisfied’ than patients who do not and that a clinically significant difference in the proportions who are ‘very satisfied’ is 15%, for example, 50% vs 35%, respectively. Approximately 80% of patients who present with a pain score ≥4 receive analgesia in our ED 18. To demonstrate a statistically significant difference in the proportions who are ‘very satisfied’ in the two patient subgroups (50% vs 35%), we needed to enrol at least 516 and 129 patients who did and did not receive analgesia, respectively (ratio 4:1, alpha 0.05, two-sided, power 0.85).…”

National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study

“…Recent studies from Australia have shown that providing adequate analgesia improves patient satisfaction . A very simple intervention that may improve patient satisfaction is to say to patients that ‘the treatment of pain is very important and be sure to tell the staff that you have pain’ . More complex educational initiatives may also result in improved quality of pain care as has previously been demonstrated in Australia with the National Pain Management Initiative .…”

Our observations with cold calling: Patient anger and undesirable experiences

“…A ‘cold call’ has been defined as a telephone call soliciting business made directly to a potential customer without prior contact or without a lead . While this definition is drawn from the commercial setting, the cold calling technique is used in emergency medicine research, especially for the collection of outcome data at patient follow up . In general, cold calling is regarded as a less than optimal research practice and our recent experience exemplifies the reasons for this.…”