Journal article
Patient and clinician factors associated with pain treatment and outcomes: Cross sectional study
American Journal of Emergency Medicine, Vol.37(2), pp.266-271
2019
Abstract
Objective: We aimed to identify how patient (age, sex, condition) and paramedic factors (sex, role) affected analgesic administration and pain alleviation. Methods: We used a cross-sectional design with a 7-day retrospective sample of adults aged 18 years or over requiring primary emergency transport to hospital, excluding patients with Glasgow Coma Scale below 13, in two UK ambulance services. Multivariate multilevel regression using Stata 14 analysed factors independently associated with analgesic administration and a clinically meaningful reduction in pain (≥2 points on 0-10 numerical verbal pain score [NVPS]). Results: We included data on 9574 patients. At least two pain scores were recorded in 4773 (49.9%) patients. For all models fitted there was no significant relationship between analgesic administration or pain reduction and sex of the patient or ambulance staff. Reduction in pain (NVPS ≥2) was associated with ambulance crews including at least one paramedic (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14 to 2.04, p < 0.01), with any recorded pain score and suspected cardiac pain (OR 2.2, 95% CI 1.02 to 4.75). Intravenous morphine administration was also more likely where crews included a paramedic (OR 2.82, 95% CI 1.93 to 4.13, P < 0.01), attending patients aged 51 to 64 years (OR 2.04, 95% CI 1.21 to 3.45, p = 0.01), in moderate to severe (NVPS 4-10) compared with lower levels of pain for any clinical condition group compared with the reference condition. Conclusion: There was no association between patient sex or ambulance staff sex or grade and analgesic administration or pain reduction.
Details
- Title
- Patient and clinician factors associated with pain treatment and outcomes: Cross sectional study
- Authors
- Aloysius Niroshan Siriwardena (Author) - University of Lincoln, United KingdomZahid Asghar (Author) - University of Lincoln, United KingdomBill Lord (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringHelen Pocock (Author) - South Central Ambulance Service NHS Trust, United KingdomViet-Hai Phung (Author) - University of Lincoln, United KingdomTheresa Foster (Author) - East of England Ambulance Service NHS Trust, United KingdomJulia Williams (Author) - University of Hertfordshire, United KingdomHelen Snooks (Author) - Swansea University, United Kingdom
- Publication details
- American Journal of Emergency Medicine, Vol.37(2), pp.266-271
- Publisher
- W.B. Saunders Co.
- Date published
- 2019
- DOI
- 10.1016/j.ajem.2018.05.041
- ISSN
- 0735-6757
- Copyright note
- Copyright © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99450671302621
- Output Type
- Journal article
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