Background and Aims Pain represents up to 78% of the reasons for emergency department (ED) use, with an average of 16% of patients having chronic pain. ED overuse could be a good indicator of a poor pain management. Our aim is to characterize patients followed by the chronic pain department (CPD) that overuse ED and understand the effectiveness of our approach to pain management.
Methods We reviewed medical records of patients observed in CPD in 2019, and selected patients with more than 6 ED visits. We followed these patients for the next two years.
Results In 2019, 1892 patients were evaluated at CPD and only 1% were classified as ED hyperusers. Of these, 79% patients were female, and the mean age was 65 years.
The average number of episodes per patient was 10 in 2019, 7 episodes in 2020 and 4 episodes in 2021. 70% of episodes were due to pain and 94% were discharged immediately.
Conclusions In our center we favour invasive regional techniques, associated with a biopsychosocial approach, and provide direct communication channels between patients and the CPD. This system is probably responsible for the low percentage of hyperusers, avoiding unnecessary use of ED.
In order to prioritizeregional procedures, we are designing a consultancy project with the primary health care, facilitating the referral of patients with indication for differentiated techniques in the early stages of pain development, preventing the development of chronic pain or reducing its impact on quality of life.
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