Prescribing Opioid Pain Relievers in the Emergency Department: Understanding and Optimizing the Encounter

Prescribing Opioid Pain Relievers in the Emergency Department: Understanding and Optimizing the Encounter

Prescribing Opioid Pain Relievers in the Emergency Department: Understanding and Optimizing the Encounter

The investigators overall study objective is to improve patients knowledge and safe use of opioid pain relievers upon discharge from the Emergency Department.

Recent studies indicate that emergency department (ED) discharge processes - including written and spoken communications - are inadequate, and patients often leave without the knowledge necessary to properly care for themselves. In the context of opioid pain relievers, this lack of knowledge is potentially dangerous, as patients may not possess the requisite knowledge for safe use of their medication or an awareness of the dangers of medication misuse. The aim of this study was to evaluate the impact of an opioid information sheet and spoken counseling on patient knowledge about opioids and safe use behaviors. The investigators conducted a randomized controlled pilot test of a dual-modality educational intervention (written information sheet and spoken counseling about opioids) to assess if the intervention can increase patient knowledge about opioid pain relievers. These activities were intended to guide future modification of educational interventions and the future development of best practices for emergency physician spoken counseling about opioid pain relievers.

Patients in this arm are discharged from the Northwestern Emergency Department with standard communication about their prescribed opioid pain medication from their care providers. They are called for a follow up survey 4-7 days after their visit.

Patients in this arm are discharged from the ED with an additional information sheet about their prescribed opioid pain medication, via the intervention titled "Additional Opioid Information". The sheet is read aloud to them by a research assistant. They are called 4-7 days later for a follow up survey.

Patients receiving this intervention are given additional information about the opioid pain medication that they are receiving in the form of a one page handout. The hand out was written in a health-literacy appropriate manner. A research assistant read the handout to them out loud, and they were given a copy to take home with them.

The primary outcome was the patients ability to identify the medication name of their prescribed opioid pain reliever upon follow-up.

In addition to the outcome of medication name patients were asked additional knowledge and recall questions including: active ingredients in the medication, knowledge about safe daily dose of acetaminophen, side effects, recall of counseling about activities to avoid (drinking alcohol, driving vehicle), knowledge about addictive potential of the medication.

Patients were queried about their home use of the medication including: pain score at home, average number of tabs per day, and satisfaction with pain reduction. Additionally they were asked about the timing of any alcohol consumption or driving in relation to the timing of medication dosing.

Patients in the intervention arm were asked how they liked the intervention using a series of question with a Likert scale.

Inclusion Criteria: prescribed an opioid pain reliever English Speaking Exclusion Criteria: Non-English Speaking Clinically unstable, psychologically impaired or intoxicated as judged by the research staff member. Chronic opioid use, defined as daily or near daily use of opioid pain relievers for the past 90 days. admitted to hospital unable to complete follow up phone interview in 4 - 7 days.