Researchers in Australia have completed a review of a trial focused on reducing opioid dispensing in emergency room settings without increasing reliance on other high-risk medications. They found that the SHAPED (Sydney Health Partners Emergency Department) trial's guideline training intervention reduced opioid dispensing by 12.3%.
In a research letter titled "Shifting From Opioids to Simple Analgesics for Emergency Care of Patients With Low Back Pain: A Secondary Analysis of the SHAPED Cluster Randomized Trial," published in the JAMA Health Forum , the team—from institutions including Laval University, Royal Prince Alfred Hospital, and the University of Sydney—suggests that SHAPED was a success. There is an ongoing conversation about opioid use in clinical settings in an effort to reduce exposure to opioids for patients in less critical need. Clinical guidelines for lower back pain consistently recommend against the use of opioids, instead advising nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol as first-line treatments.
Even with these guidelines in place, opioids are still widely prescribed in emergency room departments for lower back pain. In Australia, nearly two-thirds of lower back pain patients receive opioids in emergency rooms, whereas in the United States the percentage is much lower, at around 40% for similar patients. The SHAPED trial was launched in response to this ongoing discrepancy, aiming to align emergency room treatment practices with es.