Retrospective Chart Review of Prescribing Habits for Acute Low Back Pain in an Emergency Department

Abstract

Current research has shown that nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are equally effective in treating acute low back pain (LBP). Opioids not only have many more side effects than NSAIDs do, but also carry the risk of opioid abuse and overdose. Despite this evidence, emergency department (ED) providers are still frequently prescribing opioids for acute LBP. The purpose of this project was to review the prescribing habits of providers in a rural Mid-Atlantic ED, provide evidence-based practice teaching related to the results found, and to develop an Acute Low Back Pain Protocol. The Model for Evidence-Based Practice Change, 4 robust systematic reviews, and 10 total quantitative research studies were used to support and guide this doctoral project. A retrospective chart review including data from January through June of 2017 was conducted. Data regarding subject’s Numeric Rating Scale scores, the type of provider seen, the treatment the provider prescribed, and demographic data were collected from the electronic health record. Measures of central tendency revealed that opioids were the most commonly prescribed class of medication for acute LBP in the study ED. Chai square tests indicated that there is a difference in prescribing habits for patients who present with work-related acute LBP. An Acute Low Back Pain Protocol was developed and presented to the ED providers. Provider awareness of current prescribing habits in the study ED compared to evidence-based practice recommendations may help to reduce the indiscriminate prescribing of opioids for acute LBP and decrease the potential for opioid abuse.