- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT02799004
How Much Opioids Do You Need After Your Emergency Department Visit
Opioid Prescription for Patient With Acute Pain After Discharge From Emergency Department: Ideal Duration for Adequate Relief, Adverse Events, and Addiction
Pain is one of the most common complaints in emergency department (ED) and is still often poorly managed. A major prospective multicenter study reported that 74% of patients that had a pain complaint at ED triage are discharged in moderate to severe pain. Accordingly, physicians frequently prescribed analgesic after discharged for these patients, and opioid is given in 29% of ED visits involving pain complaints. However, few studies evaluate pain management after ED discharge: the frequency and length of opioids prescriptions, the opioids quantity taken by the patients, are the patients relieved and satisfied by these pain treatments, what are the adverse effects associated with the use of these medications, and what are the chances of developing addiction?
The primary aim of this study is to determine the required minimal opioids prescription for patients treated for acute pain after being discharge from the ED. Secondary objectives include: 1) monitor the patients' adverse events during opioids treatment; 2) evaluate the patients' level of pain relief associated with their respective opioids treatment; 3) determine the patients' level of addiction following post-ED opioids treatments.
The design of the project is a prospective observational cohort study. A cohort of consecutive ED patients aged 18 or more with an initial pain at triage of 4 or more and discharged from the ED in less than 48 hours with a prescription of opioid will be asked to participate in the study. Patients will be excluded if there is ongoing treatment for a pre-existing chronic pain condition or if they used opioid drugs in the past year. Research nurses will contact the patients by phone at three follow-up time points (1 week, 1 month, and 3 months). Follow-up phone interviews will evaluate pain intensity as well as pain treatment satisfaction (0-10 NRS), monitor adverse events, and investigate possible opioids addiction (SOWS: subjective opioid withdrawal scale). During these interviews, the nurses will also question the patients about their daily opioids usage and if they were relieved from pain.
This study will provide the base for future guidelines regarding the prescription of opioids treatment for specific pathology encountered in ED. It will also give indications on how to adjust the treatments according to adverse events and the level of addiction experienced by patients.
Přehled studie
Postavení
Podmínky
Typ studie
Zápis (Aktuální)
Kontakty a umístění
Studijní místa
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Quebec
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Montreal, Quebec, Kanada, H4J 1C5
- Hôpital du Sacré-Coeur de Montréal
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Metoda odběru vzorků
Studijní populace
A cohort of consecutive emergency department patients aged 18 or more treated for an acute pain diagnosis present for less than two weeks, with an initial pain at triage of 4 and more on a 0-10 points NRS and discharged with a prescription of opioids.
The study will take place in an emergency department of a tertiary (trauma specialized center) academic urban hospital with an annual census of approximately 60,000 ED visits.
Popis
Inclusion Criteria:
- 18 years and older
- Pain level at 4 or greater at triage
- Acute pain (2 weeks or less)
- Opioids prescription at discharge
Exclusion Criteria:
- Language barrier
- Pregnancy
- Treated for chronic pain
- Hospital stay greater than 48 hours
Studijní plán
Jak je studie koncipována?
Detaily designu
- Observační modely: Kohorta
- Časové perspektivy: Budoucí
Kohorty a intervence
Skupina / kohorta |
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Patients in acute pain
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Opioids consumption
Časové okno: 2 weeks
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The number of opioids taken after ED discharge for a given pathology
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2 weeks
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Side effects
Časové okno: 2 weeks
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Recorded undesirable side effect associated with post-emergency opioids treatment
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2 weeks
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Pain relief
Časové okno: 2 weeks
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Patients' pain relief associated with a given prescription for a specific pathology
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2 weeks
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Addiction
Časové okno: 3 months
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Patients opioids addiction at three month following a post-emergency prescription
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3 months
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Spolupracovníci a vyšetřovatelé
Publikace a užitečné odkazy
Obecné publikace
- Daoust R, Paquet J, Cournoyer A, Piette E, Morris J, Lessard J, Lavigne G, Chauny JM. Relationship between acute pain trajectories after an emergency department visit and chronic pain: a Canadian prospective cohort study. BMJ Open. 2020 Dec 7;10(12):e040390. doi: 10.1136/bmjopen-2020-040390.
- Daoust R, Paquet J, Gosselin S, Lavigne G, Cournoyer A, Piette E, Morris J, Castonguay V, Lessard J, Chauny JM. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. Acad Emerg Med. 2019 Aug;26(8):847-855. doi: 10.1111/acem.13628. Epub 2019 Jul 18.
- Daoust R, Paquet J, Cournoyer A, Piette E, Morris J, Lessard J, Castonguay V, Williamson D, Chauny JM. Side effects from opioids used for acute pain after emergency department discharge. Am J Emerg Med. 2020 Apr;38(4):695-701. doi: 10.1016/j.ajem.2019.06.001. Epub 2019 Jun 3.
- Daoust R, Paquet J, Cournoyer A, Piette E, Morris J, Lessard J, Castonguay V, Lavigne G, Chauny JM. Acute Pain Resolution After an Emergency Department Visit: A 14-Day Trajectory Analysis. Ann Emerg Med. 2019 Aug;74(2):224-232. doi: 10.1016/j.annemergmed.2019.01.019. Epub 2019 Feb 21.
- Daoust R, Paquet J, Cournoyer A, Piette E, Morris J, Gosselin S, Emond M, Lavigne G, Lee J, Chauny JM. Quantity of opioids consumed following an emergency department visit for acute pain: a Canadian prospective cohort study. BMJ Open. 2018 Sep 17;8(9):e022649. doi: 10.1136/bmjopen-2018-022649.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 2016-1271
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
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