Table 2.
Factors predicting effective pain management.
| Predictor (odds of achieving effective* pain reduction) | Study | |||
|---|---|---|---|---|
| Bendall et al. (2011) AOR (95% CI) | Jennings et al. (2015)** AOR (95% CI) | Lord et al. (2019)** AOR (95% CI) | Whitley et al. (2020) AOR (95% CI) | |
| Child sex | ||||
| Male | 1.42 (1.19–1.71) | 1.1 (1.0–1.3) | 1.17 (0.98–1.39) | |
| Child age, years | ||||
| 5–9 (compared to 10–15) | 1.33 (1.00–1.75) | |||
| 5–9 (compared to 0–4) | 0.7 (0.6–0.95) | |||
| 10–14 (compared to 0–4) | 0.5 (0.4–0.6) | |||
| >9 (compared to <3) | 0.49 (0.23–1.06) | |||
| 0–5 (compared to 12–17) | 1.53 (1.18–1.97) | |||
| 6–11 (compared to 12–17) | 1.49 (1.21–1.82) | |||
| Type of pain | ||||
| Abdominal pain/problems (compared to trauma) | 0.69 (0.50–0.96)a | |||
| Musculoskeletal (compared to medical) | 1.7 (1.5–1.9) | |||
| Burns (compared to medical) | 1.6 (1.1–2.5) | |||
| Trauma (other) (compared to medical) | 1.4 (1.1–1.9) | |||
| Cardiac (compared to musculoskeletal) | 0.22 (0.08–0.60) | |||
| Trauma (compared to medical) | 1.18 (0.97–1.43) | |||
| Initial pain score | ||||
| Moderate (4–7/10) (compared to 3/10) | 3.9 (3.3–4.6) | |||
| Severe (8–10/10) (compared to 3/10) | 7.5 (6.2–9.0) | |||
| Analgesic agent | ||||
| Methoxyflurane (compared to IV morphine) | 0.52 (0.36–0.74) | |||
| Methoxyflurane (compared to IN fentanyl) | 0.43 (0.29–0.62) | |||
| Methoxyflurane (compared to no analgesia) | 5.3 (4.8–5.9) | |||
| Fentanyl (IN & IV) (compared to no analgesia) | 2.8 (2.3–3.3) | |||
| Morphine (IV) (compared to no analgesia) | 2.8 (2.2–3.6) | |||
| Any analgesic (compared to no analgesic) | 6.6 (5.9–7.3) | |||
| Analgesic administered (compared to no analgesic) | 2.26 (1.87–2.73) | |||
| Index of multiple deprivationb | ||||
| Low deprivation (compared to high deprivation) | 1.37 (1.04–1.80) | |||
| Medium deprivation (compared to high deprivation) | 1.41 (1.11–1.79) | |||
| Clinician rank | ||||
| Paramedic crew (compared to non-paramedic crew) | 1.46 (1.19–1.79) | |||
| Implementation of IN fentanyl | ||||
| After implementation of IN fentanyl (compared to before implementation) | 2.33 (1.71–3.17) | |||
| Trend after intervention on IN fentanyl (compared to before implementation) | 0.97 (0.95–1.0) | |||
Note: AOR: adjusted odds ratio; CI: confidence interval; IN: intranasal; IV: intravenous.
*Bendall et al. (2011) (reduction ≥30%), Jennings et al. (2015), Lord et al. (2019) and Whitley et al. (2020) (reduction ≥2/10).
**Jennings et al. (2015) and Lord et al. (2019) used the same base dataset; therefore, the predictor ‘child sex’ was excluded for Lord et al. (2019).
aUnadjusted odds ratio.
bIndex of multiple deprivation data from UK ministry of housing, communities and local government 2015 (deciles used and categorised as 1–3 (low), 4–7 (medium) and 8–10 (high).