Chronic Pain Treatment Guideline for Emergency Department Providers in an Urban Community Hospital

Problem: Chronic pain affects over 100 million adults in the United States. Opioids are commonly used to manage chronic pain with substance abuse and narcotic overdose being on the rise and of national concern. Emergency department (ED) providers are on the frontlines in treating patients with chronic pain and are frequently called upon to prescribe opioid medications. Currently, standardized guidelines are not being utilized sufficiently in supporting ED providers to consistently and adequately treat these patients. A clear guideline and chronic pain resource guide were developed and implemented in an inner city community hospital ED. Methods: A pre-survey was conducted to evaluate current management strategies and feelings of system support to six providers. A guideline and resources were developed with regular review prior to implementation. After a four-week implementation period, a post-survey was distributed to determine effectiveness. Results: There was significance in provider satisfaction of having resources available post-intervention (P=0.003; M=1.83±0.16, M=3.67±1.86). Providers' feelings of organizational support were at threshold of being significant (P=0.0509) with an increase in average post-survey score (M=3.33±1.06) compared to pre-survey score (M=2.67±0.66). Conclusion: Chronic pain management will continue to be a condition ED providers will need to treat and address. Results of this study demonstrated the success and satisfaction amongst ED providers in having supportive resources for better management. More appropriate management through an increase in provider consistency and patient education can impact the nationwide opioid crisis.