Prevalence, predictors and trends of opioid prescribing for lower back pain in united states emergency departments.

Title

Prevalence, predictors and trends of opioid prescribing for lower back pain in united states emergency departments.

Creator

Walkerly A; Neugebauer RE; Misko B; Shively Danielle; Singh S; Chahda B; Dhanireddy S; King K; Lloyd M; Fosnight S; Costello M; Palladino C; Soric M

Publisher

Journal of Clinical Pharmacy and Therapeutics

Date

2020
2020-12-11

Description

WHAT IS KNOWN AND OBJECTIVE: Current evidence-based guidelines for the treatment of acute low back pain (ALBP) recommend the use of opioid medications only after failure of nonpharmacological therapy, non-steroidal anti-inflammatory drugs and skeletal muscle relaxants and after thorough evaluation of risks and benefits. Despite this recommendation and the state of the opioid epidemic in the United States (US), opioids remain a common drug of choice for ALBP in the emergency department (ED). The purpose of this study was to quantify the prevalence and identify predictors of opioid prescribing for acute lower back pain (ALBP) in emergency departments (EDs) in the United States. METHODS: This was a national, cross-sectional study of the National Hospital Ambulatory Care Survey from 2013-2016. ED visits for patients aged ≥18 years treated for ALBP were included. Patients presenting with specified reasons that an opioid may be indicated were excluded. The primary endpoint was frequency of opioids prescribed. A multivariate logistic regression model identified patient- and provider-level predictors of opioid use. RESULTS AND DISCUSSION: This analysis included 2260 visits for ALBP. Opioids were prescribed in 32.3% of visits. Positive predictors of opioid prescribing were pain score of 7-10 (OR 1.85; 95% CI 1.26-2.70), and patients seen in the Southern (OR 2.53; 95% CI 1.47-4.36) or Western US (OR 2.10; 95% CI 1.19-3.70). Opioids were prescribed less often to patients who received a NSAID or acetaminophen (OR 0.38; 95% CI 0.28-0.52 and OR 0.03; 95% CI 0.01-0.10, respectively). WHAT IS NEW AND CONCLUSION: Opioid prescribing rates for ALBP remain high and the predictors identified demonstrate that this prescribing pattern is not uniformly distributed across the patient and provider characteristics studied.

Subject

low back pain; opioid; opioid prescribing; pain

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

ISSN

1365-2710 0269-4727

NEOMED College

NEOMED College of Pharmacy Student
NEOMED College of Pharmacy

NEOMED Department

NEOMED Student Publications
Department of Pharmacy Practice

Update Year & Number

January 2021 List

Citation

Walkerly A; Neugebauer RE; Misko B; Shively Danielle; Singh S; Chahda B; Dhanireddy S; King K; Lloyd M; Fosnight S; Costello M; Palladino C; Soric M, “Prevalence, predictors and trends of opioid prescribing for lower back pain in united states emergency departments.,” NEOMED Bibliography Database, accessed May 5, 2021, https://neomed.omeka.net/items/show/11512.

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