Introduction of a modified analgesic ladder in the emergency department: Effect on oxycodone use for back pain

摘要: Objective: The aim of this study was to assess the introduction an analgesic ladder and targeted education on oxycodone use for patients presenting emergency department (ED). Design: A retrospective pre-post implementation conducted. Data were extracted from June July 2016 (preintervention) 2017 (post-intervention). Setting: EDs a major metropolitan health service affiliated community-based hospital. Participants: Patients with back pain where nonpharmacological interventions such as mobilization physiotherapy are recommended mainstay treatment. Interventions: modified introduced in May 2017. promoted simple analgesics paracetamol nonsteroidal anti-inflammatory drug (NSAIDs) prior opioids tramadol preference selected patients. Main outcome measure(s): proportion prescribed total doses administered. Results: There 107 pre post-intervention included study. After ladder, 78 (72.9 percent) preintervention 55 (51.4 received ED (p = 0.001). median administered 14 mg (interquartile range: 5-20 mg) 5 5-10 mg; p < 0.001), respectively. On discharge hospital, prescription issued 36 (33.6 26 (24.3 0.13). Conclusions: Among pain, associated statistically significant but modest reduction prescription. Consideration multifaceted produce sustained changes opioid prescribing is required.