Building an emergency department cohort for chronic pain prevention: First-year recruitment, retention, and baseline findings from PREVENT
Michael Ray, Keith Meldrum, Timothy McCall, Emma Camryn Talley, Aditya Loganathan, Isabella Lagunzad, Ryan Heidish, Taylor Bolden, Charlotte Jewell, Sadichhya Shahi, Andrew C. MeltzerAbstract
Introduction:
Acute musculoskeletal pain is a common reason for emergency department (ED) care, but ED-based cohorts designed to support chronic pain prevention research remain limited. We evaluated first-year recruitment, retention, and baseline characterization in PREVENT, an ED-based observational cohort of adults with acute musculoskeletal pain.
Methods:
We analyzed first-year data from PREVENT, conducted in an urban academic ED. Adults with acute neck or low back pain were screened and enrolled during the index ED visit. Feasibility outcomes included screening, eligibility, enrollment, and completion of 1-, 3-, and 6-month follow-up assessments. Baseline measures characterized pain-related cognition, psychological symptoms, function, and social needs. Social needs burden (SNB) was categorized as 0, 1, or ≥2 endorsed domains. Associations between SNB and baseline outcomes were examined using general linear models and Fisher’s exact tests.
Results:
Between January 21, 2025 and March 22, 2026, 439 individuals were screened, 81 were eligible, and 46 were enrolled. The most common reason for ineligibility was absence of a qualifying traumatic mechanism. Follow-up completion was 22.5% at 1 month, 13.2% at 3 months, and 17.9% at 6 months; 65% completed no follow-up assessments. At baseline, 58.5% endorsed at least one social need domain. Pain catastrophizing, fear of movement, low pain self-efficacy, maladaptive pain beliefs, and disability were common. Greater SNB was associated with higher pain-related distress, anxiety and depressive symptoms, and disability.
Conclusion:
PREVENT demonstrated feasible ED-based recruitment and baseline phenotyping, while identifying retention challenges. Findings support refined follow-up procedures and risk-informed approaches to ED-initiated chronic pain prevention studies.