{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:49:26Z","timestamp":1777477766813,"version":"3.51.4"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study aimed to define the proportion of children who seek assistance for poorly controlled fracture pain, identify factors associated with requesting help, and explore caregivers' opioid preferences.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We enrolled 251 children and their caregivers in the orthopedic surgery clinic of a tertiary care children\u2019s hospital. Children 5 to 17 years old presenting within 10 days of injury for follow-up for a single-extremity, nonoperative long bone fracture(s) were eligible. The primary outcome was seeking unscheduled evaluation or advice for poorly controlled pain before the first routine follow-up appointment by telephone call, medical visit, or rescheduling to an earlier appointment. Factors associated with the outcome were assessed using bivariable analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Overall, 7.3% (95% confidence interval, 4.1%\u201310.6%) of participants sought unscheduled evaluation or advice for poorly controlled pain. The 2 most common reasons were to obtain over-the-counter analgesic dosage information (64.7%) and a stronger analgesic (29.4%). These children were more likely to have a leg fracture, have an overriding or translated fracture, or require manual reduction under procedural sedation. These children had higher Patient-Reported Outcomes Measurement Information System Pain Behavior and Pain Interference scores and more anxious caregivers. One-third of caregivers expressed hesitancy or refusal to use opioids to treat severe pain, and 45.7% reported potential addiction or abuse as the rationale.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>A notable proportion of children seek assistance for poorly controlled fracture-related pain. Medical providers should target discharge instructions to the identified risk factors and engage caregivers in shared decision making if opioids are recommended.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002304","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T17:37:13Z","timestamp":1610559433000},"page":"e410-e416","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Poorly Controlled Pediatric Fracture Pain Requiring Unplanned Medical Assistance or Advice"],"prefix":"10.1097","volume":"38","author":[{"given":"Tara M.","family":"Kopp","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Norton Children\u2019s and University of Louisville School of Medicine, Louisville, KY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa 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Staff"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Wall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri","family":"Byczkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Mittiga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,1,8]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/01202412-199704000-00002","article-title":"Epidemiology of children's fractures","volume":"6","year":"1997","journal-title":"J Pediatr Orthop 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