DEPRESSION AND PAIN INTERFERENCE AMONG EMERGENCY DEPARTMENT CHRONIC PAIN PATIENTS

2.50
Hdl Handle:
http://hdl.handle.net/10755/211478
Type:
Research Study
Title:
DEPRESSION AND PAIN INTERFERENCE AMONG EMERGENCY DEPARTMENT CHRONIC PAIN PATIENTS
Abstract:
Purpose: This study analyzes outcomes of recruitment efforts in a community hospital emergency department (ED) for a web-based program targeting chronic pain patients. The specific aims are: 1) quantify recruitment rates, and 2) provide a summary of patient characteristics for those who proceed from consent to pre-intervention survey. Background: Chronic pain affects 6 million Americans at an estimated cost of $600 billion per year. An increase in ED visits from chronic pain patients coincides with an increase in opioid addiction, and deaths from unintentional overdose. Internet-based programs have shown success in moderating symptoms of pain and mood, yet recruitment rates have been as low as 11%. Exploration of recruitment methods offers an opportunity to understand how to select patients who may participate and benefit, and determine whether these programs offer a viable option for chronic pain patients. Methods: This is a descriptive, exploratory study of the recruitment phase of a randomized controlled trial that will seek to measure effects of the Chronic Disease Self-Management Program (CDSMP) web-based version. Recruitment was initiated by ED case managers and direct care RNs in face-to-face and telephone encounters. Inclusion criteria were ED patients who were: literate and English-speaking, aged 25 to 60, diagnosed with chronic non-cancer pain, presenting with pain complaint, and documented as receiving opioids. Data were collected on rates of patient consent, reasons for refusing consent, and rates proceeding to the pre-intervention survey phase of the study. These patients completed a web-based survey that included validated measurements: (1) The Brief Pain Inventory (BPI) to measure pain intensity and interference; (2) The Profile of Mood States; and, (3) Personal Health Questionnaire Depression Scale (PHQ-9). Results: Patients were approached in person during ED visits and by phone afterwards; 110 (78%) of approximately 140 agreed to contact by researchers, and 51 (47%) of those contacted signed an informed consent. Twenty (39%) successfully completed the  pre-intervention survey. Reasons given for not continuing with the study after consenting were no computer access (3), and surgery (1). The remaining 27 (53%) did not respond to phone or email messages after consenting. Participants were 25% male, 75% female with a normal distribution of ages 26-54 (Mean 40.3, SD 8.5). Four (21 %) had rural zip codes. Mean pain severity score was 5.5 (SD 1.9) and mean pain interference 7.4 (SD 1.6) on 0-to-10 scales. PHQ-9 ratings placed 40% of respondents in the moderately severe or severe depression category. Fourteen distinct pain diagnoses were reported. Implications: ED nurses and case managers present a feasible first contact to approach patients regarding interest in programs designed to address psychosocial, cognitive, and educational needs. Male and female patients from diverse age and diagnosis categories indicate willingness to trial web-based programs. More effort is needed to increase patients’ ability to progress from recruitment to CDSMP enrollment, especially among rural patients and those without computer access. Pain interference and depression remain significant unmet needs after ED interventions.
Keywords:
Chronic pain patients; Web-based program; Community Hospital Emergency Department
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5251
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleDEPRESSION AND PAIN INTERFERENCE AMONG EMERGENCY DEPARTMENT CHRONIC PAIN PATIENTSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211478-
dc.description.abstractPurpose: This study analyzes outcomes of recruitment efforts in a community hospital emergency department (ED) for a web-based program targeting chronic pain patients. The specific aims are: 1) quantify recruitment rates, and 2) provide a summary of patient characteristics for those who proceed from consent to pre-intervention survey. Background: Chronic pain affects 6 million Americans at an estimated cost of $600 billion per year. An increase in ED visits from chronic pain patients coincides with an increase in opioid addiction, and deaths from unintentional overdose. Internet-based programs have shown success in moderating symptoms of pain and mood, yet recruitment rates have been as low as 11%. Exploration of recruitment methods offers an opportunity to understand how to select patients who may participate and benefit, and determine whether these programs offer a viable option for chronic pain patients. Methods: This is a descriptive, exploratory study of the recruitment phase of a randomized controlled trial that will seek to measure effects of the Chronic Disease Self-Management Program (CDSMP) web-based version. Recruitment was initiated by ED case managers and direct care RNs in face-to-face and telephone encounters. Inclusion criteria were ED patients who were: literate and English-speaking, aged 25 to 60, diagnosed with chronic non-cancer pain, presenting with pain complaint, and documented as receiving opioids. Data were collected on rates of patient consent, reasons for refusing consent, and rates proceeding to the pre-intervention survey phase of the study. These patients completed a web-based survey that included validated measurements: (1) The Brief Pain Inventory (BPI) to measure pain intensity and interference; (2) The Profile of Mood States; and, (3) Personal Health Questionnaire Depression Scale (PHQ-9). Results: Patients were approached in person during ED visits and by phone afterwards; 110 (78%) of approximately 140 agreed to contact by researchers, and 51 (47%) of those contacted signed an informed consent. Twenty (39%) successfully completed the  pre-intervention survey. Reasons given for not continuing with the study after consenting were no computer access (3), and surgery (1). The remaining 27 (53%) did not respond to phone or email messages after consenting. Participants were 25% male, 75% female with a normal distribution of ages 26-54 (Mean 40.3, SD 8.5). Four (21 %) had rural zip codes. Mean pain severity score was 5.5 (SD 1.9) and mean pain interference 7.4 (SD 1.6) on 0-to-10 scales. PHQ-9 ratings placed 40% of respondents in the moderately severe or severe depression category. Fourteen distinct pain diagnoses were reported. Implications: ED nurses and case managers present a feasible first contact to approach patients regarding interest in programs designed to address psychosocial, cognitive, and educational needs. Male and female patients from diverse age and diagnosis categories indicate willingness to trial web-based programs. More effort is needed to increase patients’ ability to progress from recruitment to CDSMP enrollment, especially among rural patients and those without computer access. Pain interference and depression remain significant unmet needs after ED interventions.en_GB
dc.subjectChronic pain patientsen_GB
dc.subjectWeb-based programen_GB
dc.subjectCommunity Hospital Emergency Departmenten_GB
dc.date.available2012-02-20T11:57:30Z-
dc.date.issued2012-02-20T11:57:30Z-
dc.date.accessioned2012-02-20T11:57:30Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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