Process and implementation evaluation of a virtual hospital model of care for low back pain (Back@Home).

Objectives: Low back pain was the sixth most common reason for an ED visit in 2022-2023 in Australia, one-third of these patients were subsequently admitted to hospital. Therefore, we have assessed whether some patients could be diverted to alternate clinical pathways, via admission to a virtual hospital (rpavirtual), and be cared for remotely in their own homes.

Methods: Ethics approval was granted for protocols X21-0278 & 2021/ETH10967 and X21-0094 & 2021/ETH00591.

Interventions to improve the quality of low back pain care in emergency departments: a systematic review and meta-analysis.

Low back pain (LBP) is a common reason people visit Emergency Departments (ED). However, the care provided is often not aligned with guideline recommendations. Despite increasing research aiming to promote guideline-based care in EDs, interventions to best implement recommendations are unknown.

Emergency department length of stay and re-presentation rates in patients with low back pain: A medical record review study.

Background: Low back pain (LBP) is ranked in the top 10 conditions presenting to emergency departments (ED) in Australia. We aimed to investigate ED re-presentation rates and length of stay (LOS) of patients with LBP, including associated factors.

Methods: We reviewed medical records of three EDs in Sydney, Australia from January 2016 to October 2021.

Primary care seeking among adults with chronic neck and low back pain in Norway: A prospective study from the HUNT study linked to Norwegian primary healthcare registry.

Background: To describe the frequency of primary care seeking for neck or back-related conditions among people with chronic neck and low back pain and to develop prediction models of primary care seeking and frequent visits.

Methods: We included participants of the Trøndelag Health Study (HUNT4, 2017-19) in Norway who self-reported chronic neck and/or low back pain in the preceding year, and extracted data of primary care visits from the Norwegian primary healthcare registry. We investigated a total of 23 potential predictors and used multivariable logistic regression models to predict primary care seeking for neck or back-related conditions and frequent visits by healthcare provider (i.

Clinical indicators to monitor health care in low back pain: a scoping review.

Clinical care indicators for low back pain can be used to monitor healthcare practices and consequently be used to evaluate success of strategies to improve care quality. The aim of this study was to identify the clinical care indicators that have been used to measure appropriateness of health care for patients with low back pain. We conducted a systematic search of five electronic databases and Google to identify clinical care indicators that have been used to measure any aspect of care for people with low back pain.

Correction: A Virtual Hospital Model of Care for Low Back Pain, Back@Home: Protocol for a Hybrid Effectiveness-Implementation Type-I Study.

[This corrects the article DOI: 10.2196/50146.].

Perceptions and experiences of paramedics managing people with non-traumatic low back pain: a qualitative study of Australian paramedics.

Background: Paramedics are often first providers of care to patients experiencing non-traumatic low back pain (LBP), though their perspectives and experiences with managing these cases remain unclear.

Objectives: This study explored paramedic views of the management of non-traumatic LBP including their role and experience with LBP management, barriers to referral and awareness of ambulance service guidelines.

Design: Qualitative study using semistructured interviews conducted between January and April 2023.

Reinforcing informed medication prescription for low back pain in the emergency department (RIME): a controlled interrupted time series implementation study protocol.

Introduction: Management guidelines for low back pain (LBP) recommend exclusion of serious pathology, followed by simple analgesics, superficial heat therapy, early mobilisation and patient education. An audit in a large metropolitan hospital emergency department (ED) revealed high rates of non-recommended medication prescription for LBP (65% of patients prescribed opioids, 17% prescribed benzodiazepines), high inpatient admission rates (20% of ED LBP patients), delayed patient mobilisation (on average 6 hours) and inadequate patient education (48% of patients). This study aims to improve medication prescription for LBP in this ED by implementing an intervention shown previously to improve guideline-based management of LBP in other Australian EDs.

Clinical care standards for the management of low back pain: a scoping review.

The objective of this study is to compare and contrast the quality statements and quality indicators across clinical care standards for low back pain. Searches were performed in Medline, guideline databases, and Google searches to identify clinical care standards for the management of low back pain targeting a multidisciplinary audience. Two independent reviewers reviewed the search results and extracted relevant information from the clinical care standards.

A Virtual Hospital Model of Care for Low Back Pain, Back@Home: Protocol for a Hybrid Effectiveness-Implementation Type-I Study.

Background: Low back pain (LBP) was the fifth most common reason for an emergency department (ED) visit in 2020-2021 in Australia, with >145,000 presentations. A total of one-third of these patients were subsequently admitted to the hospital. The admitted patient care accounts for half of the total health care expenditure on LBP in Australia.

The effectiveness of allied health and nurse practitioner models-of-care in managing musculoskeletal conditions in the emergency department: a systematic review and meta-analysis.

Background: Musculoskeletal conditions are the most common health condition seen in emergency departments. Hence, the most effective approaches to managing these conditions is of interest. This systematic review aimed to evaluate the effectiveness of allied health and nursing models of care for the management of musculoskeletal pain in ED.

Clinicians' Perspective on Implementing Virtual Hospital Care for Low Back Pain: Qualitative Study.

Background: Alternate "hospital avoidance" models of care are required to manage the increasing demand for acute inpatient beds. There is currently a knowledge gap regarding the perspectives of hospital clinicians on barriers and facilitators to a transition to virtual care for low back pain. We plan to implement a virtual hospital model of care called "Back@Home" and use qualitative interviews with stakeholders to develop and refine the model.

Continued Opioid Use and Adverse Events Following Provision of Opioids for Musculoskeletal Pain in the Emergency Department: A Systematic Review and Meta-Analysis.

Background: The prevalence of continued opioid use or serious adverse events (SAEs) following opioid therapy in the emergency department (ED) for musculoskeletal pain is unclear. The aim of this review was to examine the prevalence of continued opioid use and serious adverse events (SAEs) following the provision of opioids for musculoskeletal pain in the emergency department (ED) or at discharge.

Methods: Records were searched from MEDLINE, EMBASE and CINAHL from inception to 7 October 2022.

Red flags to screen for vertebral fracture in people presenting with low back pain.

Background: Low back pain is a common presentation across different healthcare settings. Clinicians need to confidently be able to screen and identify people presenting with low back pain with a high suspicion of serious or specific pathology (e.g.

Process evaluation of the implementation of an evidence-based model of care for low back pain in Australian emergency departments.

Background: The Sydney Health Partners Emergency Department (SHaPED) trial targeted ED clinicians and evaluated a multifaceted strategy to implement a new model of care. The objective of this study was to investigate attitudes and experiences of ED clinicians as well as barriers and facilitators for implementation of the model of care.

Design: A qualitative study.

Global prevalence of hospital admissions for low back pain: a systematic review with meta-analysis.

Objectives: To determine the proportion of low back pain presentations that are admitted to hospital from the emergency department (ED), the proportion of hospital admissions due to a primary diagnosis of low back pain and the mean hospital length of stay (LOS), globally.

Methods: We searched MEDLINE, CINAHL, EMBASE, Web of Science, PsycINFO and LILACS from inception to July 2022. Secondary data were retrieved from publicly available government agency publications and international databases.

Australian emergency department care for older adults diagnosed with low back pain of lumbar spine origin: a retrospective analysis of electronic medical record system data (2016-2019).

Background: In Australian emergency departments, 30% of all back pain presentations are for older adults. Relatively little is known about the care that this population receives during an emergency department stay, including admission to hospital. The aim of this study is to describe emergency department management of older adults diagnosed with a lumbar spine condition and to determine predictors of healthcare use in this population.

Racial and ethnic differences in the use of lumbar imaging, opioid analgesics and spinal surgery for low back pain: A systematic review and meta-analysis.

Background And Objective: There is a substantial gap between evidence and clinical care for low back pain (LBP) worldwide despite recommendations of best practice specified in clinical practice guidelines. The aim of this systematic review was to identify disparities associated with race or ethnicity in the use of lumbar imaging, opioid analgesics, and spinal surgery in people with LBP.

Databases And Data Treatment: We included observational studies which compared the use of lumbar imaging, opioid analgesics, and spinal surgery for the management of non-serious LBP between people from different racial/ethnic populations.

Management of patients with low back pain admitted to hospital: An observational study of usual care.

Background: Knowledge gaps exist around diagnostic and treatment approaches for patients admitted to hospital with low back pain.

Methods: Medical record review of patients admitted to three Sydney teaching hospitals with a provisional emergency department diagnosis of non-serious low back pain, from 2016 to 2020. Data on demographic variables, hospital costs, length of stay (LOS), diagnostic imaging and analgesic administration were extracted.

Almost one in five physiotherapy trials excluded people due to lack of language proficiency: A meta-epidemiological study.

Objectives: The objective of the study was to examine the characteristics of randomized controlled trials (RCTs) evaluating physiotherapy interventions for low back pain (LBP) that specified a language-grounded eligibility criterion and the proportion of people being excluded consequently.

Study Design And Setting: This is a meta-epidemiological study of RCTs evaluating at least one type of physiotherapy intervention for treatment or prevention of LBP. Records were retrieved from Physiotherapy Evidence Database (PEDro), LILACS, and SciELO from inception to May 2021.