Het ontwikkelen van een predictiemodel voor de transitie van acute pijn naar pijn die meer dan 3 maanden persisteert

Pain is one of the most common presenting complaints in an Emergency Department (ED). Nevertheless, undertreatment of this pain remains a problem. The consequence of undertreatment of patients with acute pain could be the transitioning into chronic pain. Chronic pain, defined as pain lasting for more than 3 months, is an important cause of healthcare (over)utilization. The incidence of chronic pain is still unknown, yet the prevalence is estimated to be 18% in The Netherlands. Until now, studies have focused on the treatment of acute pain on an emergency department and on identifying the risk factors for developing chronic pain. Differentiating patients at risk of developing chronic pain in an early stage can help prevent chronification as these patients can receive efficient and adapted treatment at an earlier stage. To our knowledge there were a few initiatives towards the development of a prediction model to distinguish patients in an early stage whom have an increased risk of developing chronic pain. However, those studies only determined the risk factors for the development of chronic pain in specific groups of patients.



Objective: To develop a prediction model to distinguish patients with an increased risk of developing chronic pain in an early – acute pain- stage and target them to efficient and adapted treatment to prevent the development of chronic pain.



Study design: Prospective multicenter longitudinal study



Study population: Patients 18 years and older who presented to the ED for a pain related cause and are not hospitalized.



During the first 7 consecutive days after visiting the ED, after 90 and 180 days patients will be asked to complete a short questionnaire using a specifically developed electronic application. The questionnaires will concern questions about general health, quality of life and pain. The first period of the trial, for the duration of 1 month, traditional paper questionnaires will be used to compare response rate between the web-based electronic survey and paper questionnaires.

We hypothesize (based on literature) that the incidence of chronic pain in The Netherlands is around 15-20% in patients presenting to the emergency department with (acute) pain related complaints.

We have no further hypothesis, because of the observational aspect of our study. The list of candidate predictors for the development of chronic pain is based on a literature search in 2018.

1st August

Start period 1 ( Start with paper questionnaires in Franciscus Gasthuis & Vlietland)



1st September

Continuation of period 1 (Start with electronical questionaires in Franciscus Gasthuis & Vlietland)

End of paper questionnaires



1st October

Stop with period 1

Start with period 2 (inclusion in all hospitals with electronic questionnaires)



January 2019 Introduction first article

February 2019 Methods first article

March 2019 Interim analysis & start syntax

April 2019



1st May 2019 END of inclusion period in all hospitals





June 2019 Statistical analysis



July 2019 Statistical analysis



August 2019 Finalize article



September 2019 Finalize article



October 2019 Finalize article

No interventions