Public Release: 

Study finds that opioids administered in the ER don't influence patient satisfaction

Other factors such as wait time and physician communication play a greater role in patient satisfaction surveys

University of Massachusetts Medical School

WORCESTER, MA - A new study co-authored by investigators at the University of Massachusetts Medical School found that there is no correlation between opioids administered in the emergency room setting and Press Ganey ED patient satisfaction scores, one of the most commonly used metrics for measuring patient satisfaction. Based on these findings, the study's authors suggest that emergency room clinicians should administer pain medications in the emergency room setting according to clinical and patient factors without being concerned about negative Press Ganey ED patient satisfaction scores.

"Right now there is an epidemic of opioid related deaths and the FDA has identified prescribers as essential to the reduction of opioid misuse," said study author Kavita Babu, MD, associate professor of emergency medicine and director of the medical toxicology fellowship at the University of Massachusetts Medical School. "When we identify modifiable factors, things that we can change, in order to curb this epidemic, one of the issues that comes up frequently is responsible opioid prescribing."

Clinical encounters in the emergency department (ED) often involve treatment of painful conditions. However, treatment of pain and the administration of opioids in the ED can be challenging for physicians because of a lack of familiarly with the patient, time constraints and concerns about patient safety. Additionally, in some emergency medicine settings, compensation and metrics of care are linked to Press Ganey ED patient satisfaction scores which may be perceived to be adversely influenced by the failure to administer opioids.

"In conferences and settings where we teach physicians about responsible opioid prescribing, one of the obstacles frequently mentioned is patient satisfaction, and the idea that physicians might be chastised or receive less compensation because their patient satisfaction scores are low," said Dr. Babu.

Seeking to quantify and validate the concerns of their colleagues, the study's authors looked at the link between opioids administered in the emergency room and patient satisfaction scores more rigorously. The researchers matched patient satisfaction responses to the corresponding de-identified electronic medical record data of 4,749 patients seen in the emergency room of two New England hospitals. Looking at patient survey responses, as well as medication orders, age, sex, race, health insurance status, time of arrival at ER, time of wait to see a physician, total length of stay, patient-reported pain levels and year and month of visit, the investigators performed a retrospective analysis of the data.

The study found that there was no association between how much opioid pain medication was administered in the emergency room and patient satisfaction scores. Other factors such as wait time and physician and nurse communication play a far greater role in patient satisfaction, according to Babu.

"Based on these findings the administration of opioids in the emergency department setting does not make patients more satisfied," said Babu. "This suggests that emergency physicians should act in the best interest of the patient when deciding whether to prescribe or administer opioids."

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Details of the study were published in the Annals of Emergency Medicine. Press Ganey was not involved in the design of the study, data analysis, reporting of the results or composition or review of the article.

About the University of Massachusetts Medical School

The University of Massachusetts Medical School (UMMS), one of five campuses of the University system, comprises the School of Medicine, the Graduate School of Biomedical Sciences, the Graduate School of Nursing, a thriving research enterprise and an innovative public service initiative, Commonwealth Medicine. Its mission is to advance the health of the people of the commonwealth through pioneering education, research, public service and health care delivery with its clinical partner, UMass Memorial Health Care. In doing so, it has built a reputation as a world-class research institution and as a leader in primary care education. The Medical School attracts more than $240 million annually in research funding, placing it among the top 50 medical schools in the nation. In 2006, UMMS's Craig C. Mello, PhD, Howard Hughes Medical Institute Investigator and the Blais University Chair in Molecular Medicine, was awarded the Nobel Prize in Physiology or Medicine, along with colleague Andrew Z. Fire, PhD, of Stanford University, for their discoveries related to RNA interference (RNAi). The 2013 opening of the Albert Sherman Center ushered in a new era of biomedical research and education on campus. Designed to maximize collaboration across fields, the Sherman Center is home to scientists pursuing novel research in emerging scientific fields with the goal of translating new discoveries into innovative therapies for human diseases.

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