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Attributes of analgesics for emergency pain relief

results of the Consensus on Management of Pain Caused by Trauma Delphi initiative

Porter, Keitha; Morlion, Bartc; Rolfe, Markb; Dodt, Christophd

doi: 10.1097/MEJ.0000000000000597
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Objectives Management of pain is suboptimal in many prehospital and emergency department settings, and European guidelines are lacking. We carried out the Consensus On Management of PAin Caused by Trauma (COMPACT) Delphi initiative to gain insights into the factors physicians consider important when selecting analgesics for trauma pain.

Patients and methods A pan-European panel of experts in emergency medicine or pain (N=31) was recruited to participate in the COMPACT Delphi initiative. In round 1, panelists supplied free-text responses to an open question about the attributes of analgesics for emergency pain relief favored by physicians. Common themes were consolidated into factors. In round 2, factors rated important by more than 75% of the panel were taken forward into round 3. In round 3, the point at which the consensus was achieved was defined a priori as at least 75% of panelists agreeing or strongly agreeing that a factor was important.

Results Twenty-nine experts participated, representing 10 European countries and with a mean (SD) of 20 (8.6) years of clinical experience. Most worked in an emergency department (79.3%). The consensus was achieved for 10 factors that were important to consider when selecting analgesics for trauma pain relief. The highest level of consensus was achieved for ‘efficacy’ (100%), followed by ‘safety and tolerability’ (96.6%), and ‘ease of use’ (93.1%).

Conclusion These findings may facilitate the development of evidence-based guidelines supporting the provision of pain management in prehospital, emergency department, and critical care settings.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

aQueen Elizabeth Hospital, Birmingham

bOxford PharmaGenesis, Oxford, UK

cUniversity Hospitals Leuven, Leuven, Belgium

dBogenhausen Hospital, Munich, Germany

Correspondence to Christoph Dodt, MD, Emergency Medicine Center, City Hospital Munich, Englschalkingerstrasse 77, D 81925 Munich, Germany Tel: +49 899 270 3269; fax: +49 899 270 3262; e-mail: christoph.dodt@klinikum-muenchen.de

Received January 31, 2018

Accepted January 10, 2019

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