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Pain Research and Management
Volume 2018, Article ID 1875967, 10 pages
https://doi.org/10.1155/2018/1875967
Research Article

Chronic Pain in the Emergency Department: A Pilot Interdisciplinary Program Demonstrates Improvements in Disability, Psychosocial Function, and Healthcare Utilization

1Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, Canada
2The Ottawa Hospital Research Institute, Ottawa, ON, Canada
3School of Psychology & Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada
4The Ottawa Hospital Department of Psychology, Ottawa, ON, Canada
5Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
6School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
7Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

Correspondence should be addressed to Patricia A. Poulin; ac.hot@niluopp

Received 5 June 2017; Revised 6 September 2017; Accepted 25 October 2017; Published 17 January 2018

Academic Editor: Emily J. Bartley

Copyright © 2018 Joshua A. Rash 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.

Abstract

Objective. To evaluate the feasibility of an individualized interdisciplinary chronic pain care plan as an intervention to reduce emergency department (ED) visits and improve clinical outcomes among patients who frequented the ED with concerns related to chronic pain. Methods. A prospective cohort design was used in an urban tertiary care hospital. As a pilot program, fourteen patients with chronic pain who frequented the ED (i.e., >12 ED visits within the last year, of which ≥50% were for chronic pain) received a rapid interdisciplinary assessment and individualized care plan that was uploaded to an electronic medical record system (EMR) accessible to the ED and patient’s primary care provider. Patients were assessed at baseline and every three months over a 12-month period. Primary outcomes were self-reported pain and function assessed using psychometrically valid scales. Results. Nine patients completed 12-month follow-up. Missing data and attrition were handled using multiple imputation. Patients who received the intervention reported clinically significant improvements in pain, function, ED visits, symptoms of depression, pain catastrophizing, sleep, health-related quality of life, and risk of future aberrant opioid use. Discussion. Individualized care plans uploaded to an EMR may be worth implementing in hospital EDs for high frequency visitors with chronic pain.