Pediatric self-reported pain outcomes via texting following emergency department discharge: How does it compare to parent's perception?

Objectives: Compare child and parent text message reporting of pain outcomes following emergency department (ED) discharge. Methods: Children 8 to 17 years, discharged from the ED with long-bone fracture, whose parent was enrolled in the multicenter study to report their child's pain and function outcomes (R01HD091302) were enrolled in this single-center study between April 2021 and February 2022. Both respondents reported pain-related dysfunction (scale: 0 to 10), maximum pain (scale: 0 to 10), and medication dissatisfaction (scale: 1 to 4) for 7 days by text message. Average differences in outcomes between respondents were tested using a paired t-test and mixed models. Text response rate was evaluated. Results: Overall, 80 child-parent dyads were included, and 80% of children texted reports on at least 1 day, 74% for ≥3 days, and 45% for all 7 days. Parents’ overall response rate was 91% for at least 1 day, 80% for ≥3 days, and 44% for all 7 days. Compared to parents, child reports were not different for the child's dysfunction score (difference = 0.21 points, 95% CI: −0.03, 0.44; P-value = 0.086) but were higher for child's maximum pain score (0.31 points, 95% CI: 0.09, 0.52; P-value = 0.006) and dissatisfaction score (0.22, 95% CI: 0.15, 0.30; P-value = <0.001). Discussion: Children ages 8 to 17 years can report at-home pain experiences by text message at rates comparable to their parents. Children report significantly higher pain severity and dissatisfaction with pain medications, but dysfunction was similar compared to parent's report. Children and their parents can text message their at-home acute pain experiences after ED discharge.