Reducing Inappropriate Medications for low back pain in the Emergency department (RIME): a controlled interrupted time-series implementation study

People frequently present to Emergency Departments (EDs) with back pain. Following the exclusion of serious conditions requiring urgent medical care, guidelines recommend that all other patients with LBP are managed with simple pain relief medicines, are assisted to remain mobile, and are provided with advice and strategies to self-manage their recovery. However, medications, such as potentially addictive opioids and strong muscle-relaxants that are not recommended as initial treatments for back pain, are often used. These have serious side effects and contribute to the global opioid addiction crisis. 'This RIME study will, for the first time in Queensland, implement and evaluate a Sydney-developed intervention that has been shown to reduce prescription of the wrong medications for back pain'. The study will involve two metropolitan EDs from within the same health service, one which will implement the intervention strategies, while the other will act as the control site, with standard current clinical care. The intervention supports ED clinicians to follow best practice through education, treatment alternatives, and audit/feedback, to reduce inappropriate medication prescription and hospital admissions.