Behavioral Intervention Cuts ER Use for Chronic Pain

Consultation in emergency department sharply reduces visits for high-utilization group
By Jeff Muise
HealthDay Reporter

WEDNESDAY, Sept. 29 (HealthDay News) -- The inappropriate use of hospital emergency departments by patients seeking relief from chronic pain can be reduced by a behavioral intervention in the emergency department, especially among high-utilization patients, according to a study in the September issue of the Journal of Emergency Nursing.

Jonathan Woodhouse, of George Fox University in Newberg, Ore., and colleagues identified 25 patients with high and low utilization of a hospital emergency department for relief of chronic pain. The researchers tracked the two groups' utilization six months before and after a behavioral intervention in the emergency department. The intervention involved a 15- to 30-minute consultation in which the patient was taught pain management strategies, and the need for a primary care physician (PCP) to manage pain medication was reinforced. The consultations also included referrals to a PCP and to a pain management group.

The researchers found that, in the six months after the intervention, the low-utilization group used the emergency department a mean 1.42 times compared to 1.83 times in the six months prior to the intervention; however, the high-utilization group reduced its mean utilization more substantially -- to 4.0 from 6.77.

"This study suggests that an emergency department-based behavioral health consultation may be useful for reducing high utilization of emergency department services by some chronic pain patients, particularly those who consume the most services," the authors write.

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