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Observational Study
. 2025 Sep 11:26:e77.
doi: 10.1017/S146342362510042X.

From acute to chronic: the PREVENT protocol for understanding pain progression after emergency department visits

Michael Ray  1 , Andrew C Meltzer  1 , Timothy C McCall  2 , Keith Meldrum  3
Affiliations
Observational Study

From acute to chronic: the PREVENT protocol for understanding pain progression after emergency department visits

"VSports注册入口" Michael Ray et al. Prim Health Care Res Dev. .

Abstract

Aim: The Pain Recognition and Evaluation to Validate Effective Neck and back Treatment (PREVENT) study aims to identify cognitive, behavioral, and treatmentrelated predictors of chronic musculoskeletal pain (CMP) development following emergency department (ED) care for acute neck or back pain after trauma. VSports手机版.

Background: CMP is a leading cause of global disability, yet early risk factors for its development remain poorly characterized, particularly in ED settings. This prospective observational study will recruit 246 adult patients presenting with acute (≤ 4 weeks) neck or back pain after a recent trauma. Pain beliefs - measured using pain and attitude questionnaires - serve as the primary independent variable. Mediating variables include catastrophic thinking, fear-avoidance behaviors, low physical activity, poor recovery expectations, and low self-efficacy for pain management. Covariates include demographics, social determinants of health, mental health disorders, and high-risk substance use. The primary outcome is the presence of CMP at six months, defined as pain on most or every day for at least three months. Participants will complete follow-ups at 1, 3, and 6 months. Multivariable logistic regression, mediation analyses, and interaction testing will explore effects of pain beliefs on CMP development. As a secondary aim, a subset of participants will complete Think Aloud cognitive interviews to assess response process validity for the Neck Pain Attitudes Questionnaire (Neck-PAQ), a region-specific adaptation of the Back Pain Attitude Questionnaire, analyzed using a deductive content analysis framework V体育安卓版. .

Discussion: This study is among the first to investigate the cognitive and behavioral predictors of pain chronification in the ED. Ethical approval has been obtained from The George Washington University Institutional Review Board. Findings will inform the design of targeted, ED-based screening and intervention strategies, including adaptation of a pain-specific Screening, Brief Intervention, and Referral to Treatment (SBIRT) model V体育ios版. Results will be disseminated through peer-reviewed publications, conferences, and stakeholder engagement. .

Keywords: Acute pain; emergency medicine; low back pain; neck pain; prevention VSports最新版本. .

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Cognitive Risk Model for Chronic Musculoskeletal Pain. This directed acyclic graph (DAG) illustrates hypothesized pathways through which pain beliefs influence the development of chronic musculoskeletal pain (pain frequency) following an ED visit. Psychological and behavioural mediators (grey), confounding variables (white), and primary outcome (blue) are shown, with arrows representing theorized causal relationships.
Figure 2.
Figure 2.
Study Flowchart. Flowchart outlining the PREVENT study procedures for participant screening, enrolment, and follow-up. Potential participants are identified through electronic medical record pre-screening, followed by in-person eligibility assessment and informed consent. Enrolled participants complete baseline forms and are followed at 1-, 3-, and 6-month intervals, with chart audits conducted at the 1- and 6-month time points. Screening logs are completed for all screened individuals regardless of eligibility or consent status.
Figure 3.
Figure 3.
Think Aloud Cognitive Model. This model outlines the cognitive processes engaged by participants during the Think Aloud protocol, including comprehension, recall of relevant knowledge, evaluation of truthfulness, decision making and response selection, and optional reflection and adjustment. Each stage highlights key cognitive skills involved, such as reading comprehension, analytical reasoning, and judgement, used to interpret and respond to pain-related questionnaire items.
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References

    1. Barata IA, Shandro JR, Montgomery M, Polansky R, Sachs CJ, Duber HC, Weaver LM, Heins A, Owen HS, Josephson EB and Macias-Konstantopoulos W (2017) Effectiveness of SBIRT for alcohol use disorders in the emergency department: a systematic review. Western Journal of Emergency Medicine 18(6), 1143–1152. - PMC - PubMed
    1. Barnett ML, Olenski AR and Jena AB (2017) Opioid-prescribing patterns of emergency physicians and risk of long-term use. New England Journal of Medicine 376(7), 663–673. - PMC - PubMed
    1. Beaudoin FL, Merchant RC, McConaghy JR, et al. (2020) Predicting the transition to chronic pain 6 months after an emergency department visit for acute pain: a prospective cohort study. Journal of Emergency Medicine 59(4), 496–507. - PMC - PubMed
    1. Bourassa KJ, Lalonde L, Racine M, Choinière M, Moulin DE and Gordon A (2020). Relationship between acute pain trajectories after an emergency department visit and chronic pain: a Canadian prospective cohort study. BMJ Open 10(12), e040390. - "V体育安卓版" PMC - PubMed
    1. Brown OS, Hu L, Demetriou C, Smith TO and Hing CB (2020) The effects of kinesiophobia on outcome following total knee replacement: a systematic review. Archives of Orthopaedic and Trauma Surgery 140(12), 2057–2070. - PubMed

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