A Qualitative Assessment of Emergency Physician Perceptions and Experiences with Acute Pain Management
Moderator
Scott Keating, MS, MSc, Vertex Pharmaceuticals, Inc., Boston, MA, United States
Speakers
Scott Weiner; Emilio Garcia; KD Jacobs; Elizabeth Brennan; Laura Tesler-Waldman, PhD; Ann Menzie, MS
OBJECTIVES: To understand emergency physician perceptions of the challenges and facilitators related to acute pain management in adult patients.
METHODS: This cross-sectional, qualitative study analyzed responses from emergency physicians who manage acute pain. Individual interviews were conducted using a semi-structured interview guide; coding and thematic analyses were performed based on narrative responses and thematic saturation was reached. This study was reviewed and approved by a central institutional review board.
RESULTS: Interviews were conducted with 15 emergency physicians. Most physicians were male (n=9, 60.0%), white (n=8, 53.3%), had a median (range) of 23 (11-29) years of clinical experience, and worked a median (range) of 14 (8-20) shifts in an emergency setting per month. Physicians reported being “satisfied” (n=5, 33.3%), “moderately satisfied” (n=9, 60.0%) or “very unsatisfied” (n=1, 6.7%) with current acute pain treatments. Six (40.0%) emergency physicians were comfortable prescribing opioids, eight (53.3%) reported comfort varied or were comfortable within limits, and one (6.7%) was not comfortable. Physicians described concerns prescribing opioids to patients at risk for dependency, addiction, and/or diversion; the elderly; and patients with painful chronic conditions. Several reported satisfaction with opioid analgesic efficacy (n=8, 53.3%), however, almost all (n=14, 93.3%) were concerned about adverse events, the most worrisome being respiratory depression and altered cognition. All physicians reported opioid-related administrative tasks, including checking state prescription drug monitoring databases or pharmacy shortages; about half described these tasks as burdensome. The most commonly reported ideal characteristics of an acute pain medication included an improved safety profile (86.7%), non-addictive/non-euphoric mechanism of action (73.3%), more convenient administration (53.3%), and high analgesic efficacy (46.7%).
CONCLUSIONS: This research describes the emergency physician perspective on the challenges and facilitators of managing acute pain and highlights a desire for therapeutics with improved safety, analgesic efficacy, reduced administrative burden, and no addiction potential.
METHODS: This cross-sectional, qualitative study analyzed responses from emergency physicians who manage acute pain. Individual interviews were conducted using a semi-structured interview guide; coding and thematic analyses were performed based on narrative responses and thematic saturation was reached. This study was reviewed and approved by a central institutional review board.
RESULTS: Interviews were conducted with 15 emergency physicians. Most physicians were male (n=9, 60.0%), white (n=8, 53.3%), had a median (range) of 23 (11-29) years of clinical experience, and worked a median (range) of 14 (8-20) shifts in an emergency setting per month. Physicians reported being “satisfied” (n=5, 33.3%), “moderately satisfied” (n=9, 60.0%) or “very unsatisfied” (n=1, 6.7%) with current acute pain treatments. Six (40.0%) emergency physicians were comfortable prescribing opioids, eight (53.3%) reported comfort varied or were comfortable within limits, and one (6.7%) was not comfortable. Physicians described concerns prescribing opioids to patients at risk for dependency, addiction, and/or diversion; the elderly; and patients with painful chronic conditions. Several reported satisfaction with opioid analgesic efficacy (n=8, 53.3%), however, almost all (n=14, 93.3%) were concerned about adverse events, the most worrisome being respiratory depression and altered cognition. All physicians reported opioid-related administrative tasks, including checking state prescription drug monitoring databases or pharmacy shortages; about half described these tasks as burdensome. The most commonly reported ideal characteristics of an acute pain medication included an improved safety profile (86.7%), non-addictive/non-euphoric mechanism of action (73.3%), more convenient administration (53.3%), and high analgesic efficacy (46.7%).
CONCLUSIONS: This research describes the emergency physician perspective on the challenges and facilitators of managing acute pain and highlights a desire for therapeutics with improved safety, analgesic efficacy, reduced administrative burden, and no addiction potential.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD21
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)