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Treatment of acute renal colic in a French emergency department: a comparison of simulated cases and real cases in acute pain assessment and management.

Abstract：

OBJECTIVE:Use of analgesic drugs in acute renal colic varies widely in different countries. In order to assess the prescribing patterns in acute renal colic in French emergency departments (EDs), the present study compared intentions of prescription, real prescription and evidence-based data in a sample of emergency practitioners. METHODS:A sample of 51 emergency practitioners (27 medical doctors and 24 residents) randomly selected in nine EDs in the southwest of France participated in this observational study. In a first step (January 2000), participants were asked about a simulated case of acute renal colic. In a second step, real prescriptions for the same indication were retrospectively identified and collected among hospital medical databases during a period of 6 months (July-December 1999). RESULTS:In simulated cases, non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed in 100% of cases, in addition to propacetamol (70%), antispasmodic drugs (53%) and opiate analgesics (100%). Daily dose of these drugs was underestimated in approximately 30% of cases. In real prescription, there was no significant difference in the use of NSAIDs, propacetamol and anti-spasmodic drugs. However, daily doses were more frequently underestimated, and opiate analgesics were less prescribed. Several points could explain these discrepancies: lack of knowledge about pharmacological properties, inadequate daily review of drug intake, underutilisation of opiates and insufficient clinical evaluation of pain in several centres. CONCLUSION:These results show a clear difference between intention to treat and real prescriptions for patients suffering from acute renal colic.

journal_name

Eur J Clin Pharmacol

journal_title

European journal of clinical pharmacology

authors

Jean R,Ducasse JL,Montastruc JL,Lapeyre-Mestre M

doi

10.1007/s002280100366

subject

Has Abstract

pub_date

2001-11-01 00:00:00

pages

685-9

issue

9

eissn

0031-6970

issn

1432-1041

journal_volume

57

pub_type

杂志文章

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