A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries
Abstract
STUDY DESIGN: Randomized control trial conducted between June 2000 and September 2002.
OBJECTIVE: To determine whether a short psycho-educational video shown in the Emergency Department shortly after the injury would produce follow-up pain reductions and reduced medical utilization.
SUMMARY OF BACKGROUND DATA: Chronic pain following a whiplash injury is one example of the massive medical/legal problem of chronic muscular pain. Approaches using local pain sources (trigger points) have shown promise as treatment models for this type of pain.
METHODS: 1) SETTING: Emergency Departments (ED) and urgent care (UC) facilities. 2) PATIENTS: 126 patients entering EDs or UCs. 3) INTERVENTION: PATIENTS assigned to 12-minute video or care as usual. 4) MAIN OUTCOME MEASURES: Short Form Musculoskelatal Function Assessment (SMFA), phone questionnaires assessing: narcotics use, ER use, UC use, surgical consultations, etc.
RESULTS AND CONCLUSIONS: PATIENTS viewing the video had dramatically lower pain ratings at a 1-month follow (6.09 [10.6] vs. 21.23 [17.4], P < 0.001) and this pattern held for the 3- and 6-month follow-up period. Similarly, for 17 of 21 items asked at follow-up, the video group showed superior outcomes (chi2 ranged from 5 to 35, P < 0.05, all). For example, 4% of video patients were using narcotics at 6 month post ED visit compared with 36% of controls. The brief psycho-educational video had a profound effect on subsequent pain and medical utilization.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 126 participants or records.
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