Patient Education to Improve Pain Management in Older Adults With Acute Musculoskeletal Pain: A Pilot Randomized Trial

Study Overview
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Brief Summary
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This is a three arm pilot randomized trial. Patients will be assigned to: Usual care Video education in the Emergency Department (ED) Video education in the ED plus phone follow-up at three days with geriatric pain management specialist for all patients with pain >=4/10

Detailed Description
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This is a three arm pilot randomized trial. Patients will be assigned to: Usual care Video education in the ED (10 minute interactive video) Video education in the ED plus phone follow-up at three days with geriatric pain management specialist for all patients with pain >=4/10

Official Title
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Patient Education to Improve Pain Management in Older Adults With Acute Musculoskeletal Pain: A Pilot Randomized Trial

Conditions
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Musculoskeletal Pain

Intervention / Treatment
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* Behavioral: Video
* Behavioral: Phone follow-up


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 50 and older; ED visit for acute musculoskeletal pain Exclusion Criteria: Cognitively impaired; chronic pain (daily opioid use prior to onset of pain or pain symptoms more than one month); prison; injury or pain condition requiring hospital admission.

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual care<br>Pts will receive education and follow-up based on judgment of emergency provider. | |
| Experimental: Video<br>Patients will watch 10 minute educational video | Behavioral: Video<br>* This is a 10 minute interactive video which provided information to the viewer regarding the safe and effective use of analgesics for acute musculoskeletal pain at home. The focus is on acetaminophen, NSAIDs, and opioids.<br>|
| Experimental: Video plus Phone Follow-up<br>Patients will watch 10 minute educational video and receive phone call follow-up at 3 days to assess pain symptoms. Patients with a pain score of 4 or more will receive another call with advice from a geriatric pain specialist. | Behavioral: Video<br>* This is a 10 minute interactive video which provided information to the viewer regarding the safe and effective use of analgesics for acute musculoskeletal pain at home. The focus is on acetaminophen, NSAIDs, and opioids.<br>Behavioral: Phone follow-up<br>* The call will be made by the study coordinator, who is a medical student. Any patients reporting a pain score in the past 24 hours of 4 or more will be re-contacted by an emergency physician with special training in geriatric pain management. This individual will provide recommendations to the patient regarding treatment options.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain Score | Change in Pain from emergency department (ED) visit to 30 day follow-up phone call will be measured by calculating the difference between the maximum pain score in the ED and the patient reported average overall pain severity in the past week using the 0-10 numeric rating scale for both measures.Change in pain will be reported as a negative number if the pain decreases (i.e., 10 to 8 = -2). Higher scores indicate a worse outcome. | ED visit and 30 days post-ED visit | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Experiencing Medication Side Effects | Patients were asked if they experienced any of the following side effects: fatigue, drowsiness, trouble sleeping, trouble thinking, dizziness, unsteadiness, nausea, vomiting, constipation, abdominal pain, black or bloody stool, trouble urinating, loss of appetite, itching or shortness of breath. Patients were also queried about any other side effects they had that were not on the list. Participants reporting at least one side effect were included. | 30 days after ED visit | 
| Average Overall Pain at One Month | Determined using 0-10 numerical rating scale to answer the question What is the average amount of pain you have experienced over the last week on a scale of 0-10. where 0 means no pain and 10 means pain as severe as it could possibly be. | 30 days after ED visit | 
| Mean Physical Function Scores | Using a measure of higher-level physical function based on walking, climbing stairs, and carrying bags - scores range from 0 to 12 with higher score indicating higher function. | 30 days after ED visit |