What adult patients prefer for reporting their pain levels, and frequency of reassessment when in the emergency department

• Published in: The American journal of emergency medicine 2023-11, Vol.73, p.11-16
• Main Authors: Qureshi, Isma, Harris, Tim, Pathan, Sameer A., Qureshi, Raheel S., Al-Bakri, Faten, Thomas, Stephen H., Azad, Aftab M.
• Format: Article
• Language: English
• Subjects: Accuracy; Age; Analgesia; Consent; Emergency department; Emergency medical care; Males; Pain; Pain assessment; Pain assessment tools; Pain perception; Pain score; Patients; Reassessment; Regression analysis; Sensitivity analysis
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2023.08.008

This study interviewed adult patients presenting to the emergency department (ED) for various pain conditions enquiring about their preferred tool for reporting pain severity and preferred time interval between initial assessment and subsequent pain reassessments. A prospective observational (cross-sectional) study was conducted in adult patients with acute pain in a tertiary care hospital ED setting. Patients' initial pain score was recorded using NRS (numerical rating scale) pain scale, and appropriate analgesia offered. Once the patient had been evaluated by an attending physician, a research team member interviewed the patient regarding the pain reassessment time and preferred pain assessment tool. The pain assessment tools evaluated in this study were NRS, PS (picture scale or face pain scale), VRS (verbal rating scale), and VAS (visual analogue scale). The patients were presented with the four pain assessment tools (in their primary language) through an audio-visual on an electronic tablet display. 200 (138 male, mean age 36.5 ± 11.17) patients participated in the study. With increasing age, pain reassessment interval increased by 0.19 min (95% CI 0.03–0.36 min). Males requested pain reassessment 6.7 min (95% CI 2.2–10.8) faster than females. In this study, the preferred interval for pain reassessment was reported as a mean of 22.8 (SD + −13.6) minutes. There was no relationship reported between time reassessment and pain severity (P = 0.22). Out of 200 subjects, irrespective of the initial pain scores, 100 preferred NRS. NRS was preferred by patients with mild to moderated pain due to the perception of being faster. However, patients with severe pain choose a non-NRS scale to prioritize accuracy. There was no influence found between the initial pain severity scores and the desired frequency of pain reassessment. However, associations were identified between the time for pain reassessment interval and age, sex, and geographical region. Patients with severe pain preferred PS or VRS while patients with mild/moderate pain preferred the NRS.