Published online Sep 18, 2021. doi: 10.5312/wjo.v12.i9.700
Peer-review started: February 25, 2021
First decision: March 31, 2021
Revised: April 8, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: September 18, 2021
Low back pain a major cause of emergency department (ED) visits and ranges in incidence between 49% and 80% in the United States. Patients presenting to the ED for non-emergent LBP often receive unnecessary prescriptions of opioid pain medication.
Several guidelines have been implemented to mitigate opioid prescription for low-back pain. However, the impact of such guidelines is yet to be ascertained.
This study aimed to outline the trends of annual opioid prescriptions for patients presenting to the ED with non-emergent back pain; and risk factors associated with being prescribed an opioid based prescription for non-emergent LBP in the ED.
We reviewed the National Hospital Ambulatory Medical Care Survey for all patients who presented to the ED with low back pain. Patients over 18 years of age who were not subsequently admitted were included. The primary outcome was opioid-based medication prescription. Trends and factors of opioid-based medication prescription were evaluated to identify chronological and patient-specific risk factors.
We reviewed the National Hospital Ambulatory Medical Care Survey for all patients who presented to the ED with low back pain. Patients over 18 years of age who were not subsequently admitted were included. The primary outcome was opioid-based medication prescription. Trends and factors of opioid-based medication prescription were evaluated to identify chronological and patient-specific risk factors.
Overall opioid prescription demonstrated a mild decrease over the past decade; however, a pattern of diminished hydrocodone-based medications is associated with a mild increase in tramadol-based medication prescription. This pattern may be due to recent legislative guidelines.
Further research is required to identify future trends that may be a more veritable reflection of more recent policies regulating opioid prescription for low back pain – particularly tramadol based medications.