Opioid Analgesics for Acute Fracture Pain in Adults Discharged From the ED
Acute Pain
About this trial
This is an interventional treatment trial for Acute Pain
Eligibility Criteria
Inclusion Criteria:
- >=18 Years
- live independently
- acute pain secondary to an upper extremity, lower extremity, rib, pelvic or vertebral compression fracture occurring within 7 days prior to their visit
- ED physician intends to prescribe opioid analgesic upon ED discharge
Exclusion Criteria:
- an allergy to any of the study drug (acetaminophen, polyethylene glycol 3350, codeine, oxycodone, hydromorphone)
- non-English speaking without an adequate interpreter
- already on prescribed chronic opioid pain medication
- ongoing use of sedating medications (e.g., benzodiazepines, antipsychotics)
- current substance use disorder excluding tobacco
- on opioid substitution therapy
- comorbidity representing an absolute or relative contraindication to acute opioid prescribing (ie. any medical condition requiring home oxygen, Addison's disease, dialysis dependence, obstructive sleep apnea on non-invasive positive pressure ventilation, body mass index > 45, Cushing's Disease)
- moderate to severe dementia
- inability to follow-up
- reside in a nursing home or location where a professional dispenses medications
Sites / Locations
- Mount Sinai Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Codeine
Oxycodone
Hydromorphone
Patients will be provided with 30mg tablets of codeine, instructed to take 1 tablet every 4 hours as needed for moderate to severe pain if you continue to have pain despite taking acetaminophen. Patients will also receive 500mg tablets of acetaminophen with instructions to take 1-2 tablets by mouth every 8 hours as needed for pain. Patients will also receive 17g sachets of PEG, Dissolve in 120 to 240 mL (4 to 8 ounces) of beverage and drink. Use one sachet daily as needed to prevent constipation if you are taking the opioid study drug.
Patients will be provided with 5mg tablets of oxycodone, instructed to take 1 tablet every 4 hours as needed for moderate to severe pain if you continue to have pain despite taking acetaminophen. Patients will also receive 500mg tablets of acetaminophen with instructions to take 1-2 tablets by mouth every 8 hours as needed for pain. Patients will also receive 17g sachets of PEG, Dissolve in 120 to 240 mL (4 to 8 ounces) of beverage and drink. Use one sachet daily as needed to prevent constipation if you are taking the opioid study drug.
Patients will be provided with 1mg tablets of hydromorphone, instructed to take 1 tablet every 4 hours as needed for moderate to severe pain if you continue to have pain despite taking acetaminophen. Patients will also receive 500mg tablets of acetaminophen with instructions to take 1-2 tablets by mouth every 8 hours as needed for pain. Patients will also receive 17g sachets of PEG, Dissolve in 120 to 240 mL (4 to 8 ounces) of beverage and drink. Use one sachet daily as needed to prevent constipation if you are taking the opioid study drug.