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Management of Acute Pain in the Emergency Department

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ClinicalTrials.gov Identifier: NCT00470652
Recruitment Status : Completed
First Posted : May 8, 2007
Last Update Posted : January 27, 2009
Sponsor:
Collaborator:
Societe Française de Medecine d'urgence
Information provided by:
Centre Hospitalier Universitaire Vaudois

Study Description
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Brief Summary:
Oligoanalgesia1 has been widely recognized as an issue in emergency department.The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Condition or disease Intervention/treatment
Pain Device: computer-assisted decision support

Detailed Description:
Inadequate pain management remains a major challenge for health care providers. Despite extensive research on the mechanisms of acute pain, identification of factors leading to poor pain management and development of evidence-based strategies, the transfer of this knowledge into effective clinical practices has been surprisingly slow. Oligoanalgesia1 has been widely recognized as an issue in emergency department (ED) patients. Acute pain is reported by 60-80% of ED inpatients but is frequently undertreated. Overall, an insufficient proportion of patients with acute pain receive any type of analgesia, and pain relief remains unsatisfactory. We showed that the implementation of guidelines improved pain management. However, rotation of the medical & nursing staff leads to the forgetting of guidelines. The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.
Study Design
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Study Type : Observational
Actual Enrollment : 631 participants
Time Perspective: Prospective
Official Title: Management of Acute Pain in the Emergency Department:Impact of a Computer-Assisted Support
Study Start Date : May 2007
Actual Study Completion Date : September 2008
Groups and Cohorts
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Group/Cohort Intervention/treatment
1
Pre-intervention patients admitted to our ED in the month prior to the intervention, before the 'computer-assisted decision support' is turned on (the intervention)
2
Short-term post-intervention cohort of patients admitted in the month following the initiation of the 'computer-assisted decision support' for pain management
 Device: computer-assisted decision support
at the end of the pre-intervention period, the patient flow software was modified to open popup windows automatically when pain intensity was not documented or pain was not reevaluated within the recommended interval. The popup window also detailed appropriate pain treatment guidelines based on the documented pain intensity. In addition, the patient's icon in the flow software changed from black to red when pain intensity was >4/10. After a 10-day test period, the post-intervention data collection started.
Other Names:
  • informatics
  • information technology
3
long-term post-intervention cohort of patients admitted on the 6th month following the initiation of the 'computer-assisted decision support' for pain management
 Device: computer-assisted decision support
at the end of the pre-intervention period, the patient flow software was modified to open popup windows automatically when pain intensity was not documented or pain was not reevaluated within the recommended interval. The popup window also detailed appropriate pain treatment guidelines based on the documented pain intensity. In addition, the patient's icon in the flow software changed from black to red when pain intensity was >4/10. After a 10-day test period, the post-intervention data collection started.
Other Names:
  • informatics
  • information technology


Outcome Measures
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Eligibility Criteria
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Ages Eligible for Study:   16 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Consecutive patients discharged from our ED who either had pain on admission or suffered of a new pain while in our ED
Criteria

Inclusion Criteria:

Any patient admitted to our Emergency Department who is

  • age > 16 years
  • pain lasting =< 1 week or
  • no pain on admission but pain during the ED stay

Exclusion Criteria:

  • life-threatening condition requiring immediate admission in the OR or ICU
  • no pain or pain lasting >1 week
  • inability to give informed consent (intoxicated, psychiatric disorder, language problem, prisoner)
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00470652


Locations
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Switzerland
Centre Hospitalier Universitaire Vaudois
Lausanne, Vaud, Switzerland, 1011
Sponsors and Collaborators
Centre Hospitalier Universitaire Vaudois
Societe Française de Medecine d'urgence
Investigators
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Principal Investigator: Olivier W Hugli, MD,MPH Centre Hospitalier Universiataire Vaudois
More Information
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Publications:

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Responsible Party: Hugli Olivier, MD, MPH, Centre Hospitalier Universitaire Vaudois
ClinicalTrials.gov Identifier: NCT00470652    
Other Study ID Numbers: CIU-1
First Posted: May 8, 2007    Key Record Dates
Last Update Posted: January 27, 2009
Last Verified: January 2009
Keywords provided by Centre Hospitalier Universitaire Vaudois:
pain
Pain Measurement
Decision Making, Computer-Assisted
Informatics
Additional relevant MeSH terms:
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Emergencies
Acute Pain
Disease Attributes
 Pathologic Processes
Pain
Neurologic Manifestations