Willingness to use nonpharmacologic treatments for musculoskeletal pain in the emergency department: a cross-sectional study.
Date
2022-09
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
Abstract
Objectives
Pain is an individual experience that should incorporate patient-centered care. This study seeks to incorporate patient perspectives toward expanding nonpharmacologic treatment options for pain from the emergency department (ED).Methods
In this cross-sectional study of adult patients in ED with musculoskeletal neck, back, or extremity pain, patient-reported outcomes were collected including willingness to try and prior use of various nonpharmacologic pain treatments, sociodemographics, clinical characteristics, functional outcomes, psychological distress, and nonmusculoskeletal symptoms. Least absolute shrinkage and selection operator regression identified variables associated with (1) willingness to try and (2) having previously tried nonpharmacologic treatments.Results
Responses were analyzed from 206 adults, with a mean age of 45.4 (SD 16.4) years. The majority (90.3%) of patients in ED were willing to try at least one form of nonpharmacologic pain treatment, with 70.4%, 81.6%, and 70.9% willing to try respective subcategories of active (eg, exercise), passive (eg, heat), and psychosocial (eg, prayer) modalities. Only 56.3% of patients had previously tried any, with 35.0%, 52.4%, and 41.3% having tried active, passive, and psychosocial modalities, respectively. Patient-level factors associated with willingness included pain in upper back, more severe pain-related symptoms, and functional impairments. The factor most consistently associated with treatment use was health care provider encouragement to do so.Conclusions
Patients in ED report high willingness to try nonpharmacologic treatments for pain. Higher pain severity and interference may indicate greater willingness, while health care provider encouragement correlated with treatment use. These findings may inform future strategies to increase the introduction of nonpharmacologic treatments from the ED.Type
Department
Description
Provenance
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Eucker, Stephanie A, Shawna Foley, Sarah Peskoe, Alexander Gordee, Thomas Risoli, Frances Morales and Steven Z George (2022). Willingness to use nonpharmacologic treatments for musculoskeletal pain in the emergency department: a cross-sectional study. Pain reports, 7(5). p. e1027. 10.1097/pr9.0000000000001027 Retrieved from https://hdl.handle.net/10161/25666.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke
Stephanie Ann Eucker
Stephanie Eucker, MD, PhD, FACEP is an Assistant Professor and Assistant Director of Acute Care Research in the Duke University Department of Emergency Medicine. Her primary research interest is in preventing and treating chronic pain, disability, and opioid use disorder (OUD) by incorporating innovative multimodal and nonpharmacologic pain management strategies in the Emergency Department (ED). Her broad clinical and research training includes Emergency Medicine, Bioengineering, Clinical and Translational research. Her research comprises three main synergistic areas of focus: (1) innovative nonpharmacologic ED pain care models, (2) patient-centered, personalized medicine approaches to pain care selection, and (3) transforming ED care best practices.
In the nonpharmacologic realm, Dr. Eucker is PI of a SAMHSA-funded pragmatic randomized clinical trial of acupuncture to treat acute musculoskeletal pain in the ED, to which her team has successfully recruited 599 patients with >50% identifying as African-American and/or Latinx. Her team successfully developed an approach to acupuncture that is feasible for the fast-paced ED setting, produces significantly greater pain reductions than usual care alone, and is used and rated highly acceptable by diverse ED patients with acute musculoskeletal pain.
In the patient-centered focus, she leads several ongoing studies investigating the relationship between biopsychosocial factors and pain-related outcomes in ED patients, patient expectations for ED pain management, and the relationship between post-ED care pathways and downstream opioid use.
Regarding research on improving and implementing ED best practices, Dr. Eucker is site-PI for the multi-site PROCOVAXED study aiming to improve COVID-19 vaccination rates among ED patients through multi-media informational platforms. She has been a co-investigator in a multi-center AHRQ implementation study to improve safe ED prescribing for older adults. She also leads a multi-professional quality improvement and research effort to improve naloxone and buprenorphine prescribing for ED patients with opioid overdose and OUD. She has also partnered with Durham County and other community partners to improve linkages to care through peer support specialists in the ED.
Regarding training, Dr. Eucker has mentored numerous trainees in research, including undergraduates, graduate students, medical student, resident physicians, physician assistants and junior faculty over the past several years. She is highly experienced at engaging learners at their level of understanding and interest in the research process, from novice researchers to those with extensive experience. Her mentees have coauthored numerous publications and progressed to leading projects under her mentorship.
Alexander Gordee
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.