Abstract

Background

Chronic musculoskeletal pain (MSP) affects more than 40% of adults aged 50 years and older and is the leading cause of disability in the USA. Older adults with chronic MSP are at risk for analgesic-related side effects, long-term opioid use, and functional decline. Recognizing the burden of chronic MSP, reducing the transition from acute to chronic pain is a public health priority. In this paper, we report the protocol for the Brief EducaTional Tool to Enhance Recovery (BETTER) trial. This trial compares two versions of an intervention to usual care for preventing the transition from acute to chronic MSP among older adults in the emergency department (ED).

Methods

Three hundred sixty patients from the ED will be randomized to one of three arms: full intervention (an interactive educational video about pain medications and recovery-promoting behaviors, a telecare phone call from a nurse 48 to 72 h after discharge from the ED, and an electronic communication containing clinical information to the patient’s primary care provider); video-only intervention (the interactive educational video but no telecare or primary care provider communication); or usual care. Data collection will occur at baseline and at 1 week and 1, 3, 6, and 12 months after study enrollment. The primary outcome is a composite measure of pain severity and interference. Secondary outcomes include physical function, overall health, opioid use, healthcare utilization, and an assessment of the economic value of the intervention.

Discussion

This trial is the first patient-facing ED-based intervention aimed at helping older adults to better manage their MSP and reduce their risk of developing chronic pain. If effective, future studies will examine the effectiveness of implementation strategies.

Trial registration

ClinicalTrials.gov NCT04118595. Registered on 8 October 2019.

Details

Title
Brief educational video plus telecare to enhance recovery for older emergency department patients with acute musculoskeletal pain: study protocol for the BETTER randomized controlled trial
Author
Platts-Mills, Timothy F. 1   VIAFID ORCID Logo  ; McLean, Samuel A. 2 ; Weinberger, Morris 3 ; Stearns, Sally C. 3 ; Bush, Montika 1 ; Teresi, Brittni B. 1 ; Hurka-Richardson, Karen 1 ; Kroenke, Kurt 4 ; Kerns, Robert D. 5 ; Weaver, Mark A. 6 ; Keefe, Francis J. 7 

1  University of North Carolina at Chapel Hill, Department of Emergency Medicine, Chapel Hill, USA (GRID:grid.10698.36) (ISNI:0000000122483208) 
2  University of North Carolina Hospitals, Department of Anesthesiology, Chapel Hill, USA (GRID:grid.429995.a) 
3  Gillings School of Public Health, University of North Carolina at Chapel Hill, Department of Health Policy and Management, Chapel Hill, USA (GRID:grid.10698.36) (ISNI:0000000122483208) 
4  Indiana University, Regenstrief Institute and Department of Medicine, Indianapolis, USA (GRID:grid.257413.6) (ISNI:0000 0001 2287 3919) 
5  Yale University, School of Medicine, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710) 
6  Elon University, Department of Mathematics and Statistics, Elon, USA (GRID:grid.255496.9) (ISNI:0000 0001 0686 4414) 
7  Duke University, Department of Psychology and Neuroscience, Durham, USA (GRID:grid.26009.3d) (ISNI:0000 0004 1936 7961) 
Pages
615
Publication year
2020
Publication date
Dec 2020
Publisher
Springer Nature B.V.
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13063-020-04552-3
ProQuest document ID
2730331765
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.