A Multicentered Randomized Controlled Trial Comparing the Effectiveness of Pain Treatment Communication Tools in Emergency Department Patients With Back or Kidney Stone Pain.

Autor: Meisel ZF; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Shofer F; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Dolan A; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Goldberg EB; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Rhodes KV; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Hess EP; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Bellamkonda VR; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Perrone J; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Cannuscio CC; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Becker L; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Rodgers MA; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Zyla MM; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Bell JJ; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., McCollum S; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Engel-Rebitzer E; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Tiako MJN; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Ridgeway G; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center., Schapira MM; Zachary F. Meisel, Frances Shofer, Abby Dolan, Erica B. Goldberg, Melissa A. Rodgers, Michael M. Zyla, Jeffrey J. Bell, Sharon McCollum, Eden Engel-Rebitzer, and Max Jordan Nguemeni Tiako are with the Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Karin V. Rhodes is with the Agency for Healthcare Research and Quality, Bethesda, MD. Erik P. Hess is with the Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, TN. Venkatesh R. Bellamkonda is with the Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN. Jeanmarie Perrone is with the Center for Addiction Medicine and Policy, University of Pennsylvania. Lance Becker is with the Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, NY. Carolyn C. Cannuscio is with the Center for Public Health Initiatives, University of Pennsylvania. Greg Ridgeway is with the Department of Criminology, University of Pennsylvania. Marilyn M. Schapira is with the Center for Health Equity and Research Promotion, Philadelphia VA Medical Center.
Jazyk: angličtina
Zdroj: American journal of public health [Am J Public Health] 2022 Feb; Vol. 112 (S1), pp. S45-S55.
DOI: 10.2105/AJPH.2021.306511
Abstrakt: Objectives. To compare the effectiveness of 3 approaches for communicating opioid risk during an emergency department visit for a common painful condition. Methods. This parallel, multicenter randomized controlled trial was conducted at 6 geographically disparate emergency department sites in the United States. Participants included adult patients between 18 and 70 years of age presenting with kidney stone or musculoskeletal back pain. Participants were randomly assigned to 1 of 3 risk communication strategies: (1) a personalized probabilistic risk visual aid, (2) a visual aid and a video narrative, or 3) general risk information. The primary outcomes were accuracy of risk recall, reported opioid use, and treatment preference at time of discharge. Results. A total of 1301 participants were enrolled between June 2017 and August 2019. There was no difference in risk recall at 14 days between the narrative and probabilistic groups (43.7% vs 38.8%; absolute risk reduction = 4.9%; 95% confidence interval [CI] = -2.98, 12.75). The narrative group had lower rates of preference for opioids at discharge than the general risk information group (25.9% vs 33.0%; difference = 7.1%; 95% CI = 0.64, 0.97). There were no differences in reported opioid use at 14 days between the narrative, probabilistic, and general risk groups (10.5%, 10.3%, and 13.3%, respectively; P  = .44). Conclusions. An emergency medicine communication tool incorporating probabilistic risk and patient narratives was more effective than general information in mitigating preferences for opioids in the treatment of pain but was not more effective with respect to opioid use or risk recall. Trial Registration. Clinical Trials.gov identifier: NCT03134092. ( Am J Public Health . 2022;112(S1):S45-S55. https://doi.org/10.2105/AJPH.2021.306511).
Databáze: MEDLINE
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