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Opportunity for a PhD student to join a research project to assess the comparative effectiveness of four implementation strategies (alone or in combination) for reducing emergency physician provision of opioids to patients with back pain. This design will allow us to identify optimal implementation strategies to reduce opioid prescribing at scale.
Camperdown - School of Public Health
Back pain affects 4 million Australians each year, with direct healthcare costs estimated at $3.4 billion – half of which is attributed to hospital care. Back pain is costly and a common presentation in emergency departments. In 2022–23, back pain was the 6th most common reason for all emergency department presentations in Australia. A key problem is that opioids are overprescribed – given to 70–85% of patients with back pain in emergency departments. However, we lack trial data about which implementation strategies should be used to reduce opioid prescribing at scale.
We propose a sequential multiple assignment randomised trial in emergency departments in NSW, including 8,800 patients, to test implementation strategies to reduce opioid prescribing. The trial will take place in 44 emergency departments across nine Local Health Districts (LHD) in NSW. We have investigators and active collaborations across each of these health services. The diversity of sites also ensures we investigate the process of change, where readiness to adopt guidelines is expected to vary at site level, including sites where change is resisted versus early adopters. Our primary outcome will examine the proportion of patients with back pain who receive an opioid in the emergency department. This outcome reflects the adoption of back pain guidelines and aligns with Australian indicators for judicious use of opioids.
The research team at the Institute for Musculoskeletal Health consists of experts in back pain, including clinicians and researchers. A/Prof Gustavo Machado is an experienced back pain and health service researcher with an interest in emergency care for back pain, and extensive collaborations within Royal Prince Alfred Hospital. Dr Crystian Oliveira is an early-career researcher and physiotherapist with interests in policies for musculoskeletal pain, healthcare quality, and diagnosis of low back pain. Prof Chris Maher is a global leader in back pain research and a trialist who provides leadership, mentorship and supervision.
The opportunity ID for this research opportunity is 3691