Parental Instructions for Analgesic Use in the Emergency Department

Rationale: Children with pain are often undertreated. Some parents are reluctant to give analgesics because they fear overdose, addiction and side effects. In general there seems to be a mismatch between provided information by the emergency department (ED) staff and the need for targeted information by parents. Many patients or their parents do not understand their instructions provided by the ED staff and furthermore are not aware of their lack in understanding and recall. We hypothesize that written, patient targeted and video discharge instructions at the ED will improve parents’ knowledge about pain treatment, which will improve analgesic use.


Objective: The main objective is to evaluate the effect of written, patient targeted and video discharge instructions on parents’ knowledge about pain treatment. The secondary aims are to study the effect of this implementation on patient, process and safety related outcomes. Possible confounders on recall and parent satisfaction will be assessed.


Study design: Multicenter study, conducted at the ED of the Erasmus MC and the Albert Schweitzer Hospital. The design of the study is a pre-implementation and post-implementation study; the implementation includes introduction of a written information leaflet for parents, with patient targeted instructions and an instruction video for parents. In the pre-implementation phase, usual care and in the post-implementation phase, the effect of the written information and the instruction video will be evaluated. An independent researcher will contact the parents by phone within three to five days after the ED visit. An email address will be requested and, if provided, a link to an online questionnaire will be sent by e-mail. Filling out the questionnaire is regarded as providing informed consent.


Study population: Children aged 0-12 years presenting at the ED with pain and not requiring admittance to hospital. The treating physician gave the parents a prescription for analgesics or advised its use without providing a prescription.
Intervention: Parents will receive an instruction leaflet and a link to the online instruction video. The leaflet includes the preferred dosing and schedule of the advised analgesics. General information on pain and pain treatment will be provided in both the leaflet and the video


Main study parameters/endpoints: The intervention of written instructions should improve parents’ knowledge (correct recall) with at least 15%, compared to the usual care group.

We hypothesize that written, patient targeted and video discharge instructions at the ED will

To minimize the possible influences of seasonal differences, phase one is scheduled from February until June 2016 and phase two from August until December 2016.

Parents from patients in the post-implementation phase (phase two of the study) will receive a written instruction leaflet with patient targeted information and a link to an instruction video.