Analgesic Adherence in Recently Discharged Trauma Patients: An Integrative Literature Review

Trauma is defined as injuries to tissue and organs resulting from mechanical, thermal, chemical, or electrical mechanisms. There is evidence to suggest that patients admitted to hospital for their injuries do not adhere to prescribed analgesic regimens once discharged; however, the causes and potential solutions of this have not been fully explored. Patients who have inadequate pain relief also experience delayed return to work, psychological stress, disability, and chronic pain. Objectives: To identify causes of and solutions to analgesic regimen nonadherence in recently discharged trauma patients. Design: Integrative literature review. Data Sources: A systematic search using electronic databases (PsycINFO; Embase; CINAHL; Medline) and hand-searching methods, using the terms “analgesics,” “pain,” “trauma,” and “discharge,” was conducted for the period 1990 to 2014. Review/Analysis Methods: Following a systematic screening process, the included articles were analyzed and synthesized to identify patterns, variations, and relationships. Results: Twenty-four primary research articles were examined and three main categories were identified: pain is a common and enduring experience in recently discharged trauma patients, postdischarge analgesics are inadequately prescribed and poorly used, and inadequate discharge information inhibits adequate analgesic use. Conclusion: Reasons for poor analgesic adherence in the trauma outpatient population are not well understood and there is a paucity of solutions to address this problem. Research to inform the design of an evidence-based patient discharge process and patient information tools would address this evidence-practice gap.