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Randomized Controlled Trial
. 2024 Sep 6;5(9):e243008.
doi: 10.1001/jamahealthforum.2024.3008.

Shifting From Opioids to Simple Analgesics for Emergency Care of Patients With Low Back Pain: A Secondary Analysis of the SHAPED Cluster Randomized Trial

Claudia Côté-Picard  1 , Danielle M Coombs  2   3   4 , Qiang Li  5 , Chris G Maher  2   4 , Gustavo C Machado  2   4
Affiliations
Randomized Controlled Trial

Shifting From Opioids to Simple Analgesics for Emergency Care of Patients With Low Back Pain: A Secondary Analysis of the SHAPED Cluster Randomized Trial

Claudia Côté-Picard et al. JAMA Health Forum. .
No abstract available

Plain language summary

This secondary analysis of a cluster randomized clinical trial examined a guideline-based care model for patients with low back pain, specifically whether physicians switched from opioids to low-risk or high-risk nonopioid pain medicines.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Maher reported grants from New South Wales (NSW) Health, which partially funded the SHAPED trial, and nonfinancial support from Flexeze, which provided heat wraps at no cost for the trial. He also holds several grants from the National Health and Medical Research Council and the Medical Research Future Fund outside the submitted work. Dr Machado reported grants from the NSW Agency for Clinical Innovation and Sydney Health Partners during the study. No other disclosures were reported.

Figures

Figure.
Figure.. Study Flowchart
This figure was adapted with permission from Coombs et al 2021, BMJ Quality and Safety.
See this image and copyright information in PMC

References

    1. Oliveira CB, Maher CG, Pinto RZ, et al. . Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27(11):2791-2803. doi:10.1007/s00586-018-5673-2 - DOI - PubMed
    1. Coombs DM, Machado GC, Richards B, et al. . Effectiveness of a multifaceted intervention to improve emergency department care of low back pain: a stepped-wedge, cluster-randomised trial. BMJ Qual Saf. 2021;30(10):825-835. doi:10.1136/bmjqs-2020-012337 - DOI - PubMed
    1. Gottlieb M, Bernard K. Epidemiology of back pain visits and medication usage among United States emergency departments from 2016 to 2023. Am J Emerg Med. 2024;82:125-129. doi:10.1016/j.ajem.2024.06.020 - DOI - PubMed
    1. Choosing Wisely Australia. Recommendations faculty of pain medicine, ANZCA. Accessed March 5, 2024. https://www.choosingwisely.org.au/recommendations/fpm1
    1. Gorfinkel LR, Hasin D, Saxon AJ, et al. . Trends in prescriptions for non-opioid pain medications among US adults with moderate or severe pain, 2014-2018. J Pain. 2022;23(7):1187-1195. doi:10.1016/j.jpain.2022.01.006 - DOI - PMC - PubMed

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