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Pain Research and Management
Volume 2016, Article ID 3092391, 10 pages
Research Article

Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations

1The Ottawa Hospital Research Institute, Ottawa, ON, Canada
2Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada
3The Ottawa Hospital Department of Psychology, Ottawa, ON, Canada
4Faculty of Medicine, Memorial University, St. John’s, NL, Canada
5Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
6Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
7Carleton University, Ottawa, ON, Canada
8York University, Toronto, ON, Canada
9School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada

Received 21 October 2015; Revised 10 August 2016; Accepted 6 September 2016

Academic Editor: Celeste C. Johnston

Copyright © 2016 Patricia A. Poulin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Chronic pain (CP) accounts for 10–16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives. To describe patients with CP attending the ED and identify factors contributing to their visit. Methods. We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem. Results. Fifty-eight patients (66% women; mean age 46.5, SD = 16.9) completed the study. The most frequently cited reason (60%) for ED visits was inability to cope with pain. Mental health problems were common, including depression (61%) and anxiety (45%). Participants had questions about the etiology of their pain, concerns about severe pain-related impairment, and problems with medication renewals or efficacy and sometimes felt invalidated in the ED. Although most participants had a primary care physician, the ED was seen as the only or best option when pain became unmanageable. Conclusions. Patients with CP visiting the ED often present with complex difficulties that cannot be addressed in the ED. Better access to interdisciplinary pain treatment is needed to reduce the burden of CP on the ED.