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
Open accessAbstract
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.
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Acute MSK pain can lead to chronic MSK pain.
“Importantly, the onset of MSK pain can result in a downward spiral of negative physical, social, and psychological consequences, which can lead to chronic MSK pain [4–9].”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [4]
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References 71 · Cited by 5
Research works printed but not linked: 1
- [52]Chaudhary MA Stearns SC Estimating confidence intervals for cost-effectiveness ratios: an example from a randomized trial Stat Med 1996 15 13 1447 1458 8841654
- Authors
- Platts-Mills, T. F., McLean, S. A., Weinberger, M., Stearns, S. C., Bush, M., Teresi, B. B., Hurka-Richardson, K., Kroenke, K., Kerns, R. D., Weaver, M. A., & Keefe, F. J.
- Affiliations
- University of North Carolina Hospitals (US)
- University of North Carolina at Chapel Hill (US)
- Regenstrief Institute (US)
- Yale University (US)
- Elon University (US)
- Duke University (US)
- ORCID
- Venue
- Trials
- Published
- 2020-07-06
- Volume
- 21
- Issue
- 1
- Pages
- 615-615
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC7336469
- OpenAlex
- W3038932235
- Cited by
- 5
- References
- 71
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 2 · 2021: 1
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Aging (1R01AG058702-01A1)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- chronic musculoskeletal pain, acute to chronic pain transition, older adults, emergency department patients, educational videos, telecare, primary care provider communication, opioid use, analgesic side effects, physical function, health care utilization, economic value, patient education
- MeSH terms
- Aged, Ambulatory Care, Analgesics, Emergency Service, Hospital, Humans, Middle Aged, Pain Measurement, Patient Education as Topic, Telephone, Time Factors, United States, Video Recording, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Treatment Outcome, Telemedicine, Musculoskeletal Pain
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