title: Analgesic Adherence in Recently Discharged Trauma Patients: An Integrative Literature Review.
abstract: Trauma is defined as injuries to tissue and organs resulting from mechanical, thermal, chemical, or electrical mechanisms. There is evidence to suggest that patients admitted to hospital for their injuries do not adhere to prescribed analgesic regimens once discharged; however, the causes and potential solutions of this have not been fully explored. Patients who have inadequate pain relief also experience delayed return to work, psychological stress, disability, and chronic pain.
  
  
  OBJECTIVE
  To identify causes of and solutions to analgesic regimen nonadherence in recently discharged trauma patients.
  
  
  METHODS
  Integrative literature review.
  
  
  METHODS
  A systematic search using electronic databases (PsycINFO; Embase; CINAHL; Medline) and hand-searching methods, using the terms "analgesics," "pain," "trauma," and "discharge," was conducted for the period 1990 to 2014. Review/Analysis Methods: Following a systematic screening process, the included articles were analyzed and synthesized to identify patterns, variations, and relationships.
  
  
  RESULTS
  Twenty-four primary research articles were examined and three main categories were identified: pain is a common and enduring experience in recently discharged trauma patients, postdischarge analgesics are inadequately prescribed and poorly used, and inadequate discharge information inhibits adequate analgesic use.
  
  
  CONCLUSIONS
  Reasons for poor analgesic adherence in the trauma outpatient population are not well understood and there is a paucity of solutions to address this problem. Research to inform the design of an evidence-based patient discharge process and patient information tools would address this evidence-practice gap.
authors.affiliation: Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Trauma Service, St George Hospital, Sydney, NSW, Australia. Electronic address: helen.goldsmith@sesiahs.health.nsw.gov.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Goldsmith
authors.affiliation: Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Trauma Service, St George Hospital, Sydney, NSW, Australia; St George Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Curtis
authors.affiliation: Sydney Nursing School, University of Sydney, Sydney, NSW, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: McCloughen
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D010146:Pain / Q000188:drug therapy*; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D000700:Analgesics