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Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis.

Publication ,  Journal Article
Sakamoto, JT; Ward, HB; Vissoci, JRN; Eucker, SA
Published in: Acad Emerg Med
August 2018

OBJECTIVES: Pain is a common complaint in the emergency department (ED). Its management currently depends heavily on pharmacologic treatment, but evidence suggests that nonpharmacologic interventions may be beneficial. The purpose of this systematic review and meta-analysis was to assess whether nonpharmacologic interventions in the ED are effective in reducing pain. METHODS: We conducted a systematic review of the literature on all types of nonpharmacologic interventions in the ED with pain reduction as an outcome. We performed a qualitative summary of all studies meeting inclusion criteria and meta-analysis of randomized controlled studies measuring postintervention changes in pain. Interventions were divided by type into five categories for more focused subanalyses. RESULTS: Fifty-six studies met inclusion criteria for summary analysis. The most studied interventions were acupuncture (10 studies) and physical therapy (six studies). The type of pain most studied was musculoskeletal pain (34 studies). Most (42 studies) reported at least one improved outcome after intervention. Of these, 23 studies reported significantly reduced pain compared to control, 24 studies showed no difference, and nine studies had no control group. Meta-analysis included 22 qualifying randomized controlled trials and had a global standardized mean difference of -0.46 (95% confidence interval = -0.66 to -0.27) in favor of nonpharmacologic interventions for reducing pain. CONCLUSION: Nonpharmacologic interventions are often effective in reducing pain in the ED. However, most existing studies are small, warranting further investigation into their use for optimizing ED pain management.

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Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

August 2018

Volume

25

Issue

8

Start / End Page

940 / 957

Location

United States

Related Subject Headings

  • Emergency & Critical Care Medicine
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
 

Citation

APA
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Sakamoto, J. T., Ward, H. B., Vissoci, J. R. N., & Eucker, S. A. (2018). Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis. Acad Emerg Med, 25(8), 940–957. https://doi.org/10.1111/acem.13411
Sakamoto, Jeffrey T., Heather Burrell Ward, Joao Ricardo Nickenig Vissoci, and Stephanie A. Eucker. “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis.Acad Emerg Med 25, no. 8 (August 2018): 940–57. https://doi.org/10.1111/acem.13411.
Sakamoto, Jeffrey T., et al. “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis.Acad Emerg Med, vol. 25, no. 8, Aug. 2018, pp. 940–57. Pubmed, doi:10.1111/acem.13411.
Journal cover image

Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

August 2018

Volume

25

Issue

8

Start / End Page

940 / 957

Location

United States

Related Subject Headings

  • Emergency & Critical Care Medicine
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences