title: Intervention Study with Algoplus®: A Pain Behavioral Scale for Older Patients in the Emergency Department.
abstract: Evaluation of acute pain is often difficult in older patients admitted to the Emergency Department (ED), and self-evaluation of pain is not always possible. This observational study evaluates how the systematic use of Algoplus®, a validated behavioral scale, could improve pain management of older persons admitted to the ED.
  
  
  
  The intervention study (NCT 02258503) took place in 4 steps in the ED, University Hospital Clermont-Ferrand, France. Pain assessment and analgesics prescription were collected from medical files for 3 months. For 6 months, the whole staff of the ED were trained on pain assessment and to use Algoplus®scale (3-same as step 1). To evaluate the intervention, pain assessment and analgesics prescription were compared before and after implementation by 2-sided tests with a type I error set at α = 0.05.
  
  
  
  The intervention led to systematic pain evaluation with Algoplus®in 100% of patients (≥ 75 years old, n = 434) and was completed by numeric rating scale (NRS) and other evaluations. Pearson's correlation between NRS ≥ 3 and Algoplus®< 2 was 0.61. Prescription of analgesics (+6%) especially opioids increased nonsignificantly but was similar for all patients whatever the evaluation.
  
  
  
  The systematic introduction of Algoplus®scale in the ED allowed a change in practice by improving evaluation and management of pain in patients ≥ 75 years old, especially when difficult to be evaluated. Algoplus®allowed an objective levelling of analgesics prescription in all admitted patients. It also promoted field action to improve pain management in ED.
authors.affiliation: Emergency Department, CHU, Clermont-Ferrand, France.
authors.forename: Fares
authors.initials: F
authors.lastname: Moustafa
authors.affiliation: CHU Clermont-Ferrand, Clinical Pharmacology Department, Clermont-Ferrand, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Macian
authors.affiliation: CHU Clermont-Ferrand, Clinical Pharmacology Department, Clermont-Ferrand, France.
authors.forename: Fatiha
authors.initials: F
authors.lastname: Giron
authors.affiliation: Emergency Department, CHU, Clermont-Ferrand, France.
authors.forename: Jeannot
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: CHU Clermont-Ferrand, Biostatistics Unit, Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: CHU Clermont-Ferrand, Clinical Pharmacology Department, Clermont-Ferrand, France.|Inserm 1107 and 1405, Clermont-Ferrand, France.|Pharmacology Department, Medical Faculty, Clermont University, Clermont-Ferrand, France.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Pickering
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*
chemical_list: D000700:Analgesics
keywords: acute care; acute pain service; assessment; elderly; older adults; pain