Moving Towards Patient-Centered Care in the Emergency Department: Importance of Improvement in Pain-Related Outcomes

Musculoskeletal pain is a common emergency department (ED) presentation. Patient-centered care for patients with musculoskeletal pain may improve quality-of-life, satisfaction with care, and clinical outcomes. Providing patient-centered care in the ED requires understanding patients’ goals and priorities. We conducted a cross-sectional survey of the demographic, clinical, and biopsychosocial characteristics of adult ED patients (n=215) with musculoskeletal pain. Patients completed the Patient Centered Outcomes Questionnaire (PCOQ) to quantify importance of improvements in pain, interference with daily activities, fatigue, and emotion. Improvement ratings were from 0 (unimportant) to 100 (most important) and cluster analysis identified patient subgroups by these ratings. Comparisons used Kruskal-Wallis tests for continuous measures and Chi-Square tests for categorical measures. Patients with completed PCOQ were analyzed (n=176). All domains were rated as highly important (median/mean (sd) pain, interference, fatigue, and emotion ratings 100/91 (18), 96/79 (32), 93/72 (35), and 93/69 (39)). Cluster analysis identified three subgroups: 1) Multiple domains important (MDI, n=120) characterized by high importance for all domains 2) pain and function important (PFI, n=34) with high importance in pain and interference domains, and 3) only pain domain important (PI, n=22). The MDI group reported higher psychological symptoms, (p