Effect of a Walking Plus Education Program on the Duration and Severity of Recurrences of Low Back Pain: A Secondary Exploratory Analysis of the WalkBack Trial.

To explore the effect of the WalkBack intervention on the duration and severity of low back pain in participants who reported a recurrence. Secondary exploratory analysis of the WalkBack randomized controlled trial. The WalkBack trial compared an individualized and progressive walking plus education program delivered by physiotherapists, to a no-treatment control group for preventing new recurrences of low back pain.

Spinal cord stimulation patterns of care, re-interventions, and costs for private health insurers, Australia, 2011-22: a retrospective observational study.

Objectives: To investigate spinal cord stimulation patterns of care, the proportions of people who require unplanned surgical interventions after receiving definitive spinal cord stimulator implants, and the costs to private health insurers in Australia.

Study Design: Retrospective observational study; analysis of deidentified private health care insurers benefits payments data.

Setting, Participants: People admitted to hospital for spinal cord stimulation-related surgical procedures, 11 January 2011 - 13 April 2022, with full or partial costs coverage by five general private health care insurers.

The smallest worthwhile effect of surgery versus non-surgical treatments for sciatica: a benefit-harm trade-off study.

Question: What is the smallest worthwhile (SWE) effect of discectomy compared with non-surgical treatments amongst people with sciatica?

Design: Benefit-harm trade-off study.

Participants: People with sciatica of any duration living in Australia and recruited through social media.

Outcome: The outcome of interest was leg pain intensity.

Comparative Effectiveness of Different Opioid Regimens, in Daily Dose or Treatment Duration, Prescribed at Surgical Discharge: a Systematic Review and Meta-Analysis.

Background: Opioids are prescribed for postsurgical pain management, but a balance between achieving adequate pain control and minimising opioid-related harm is required. This study aimed to investigate the effectiveness of different opioid regimens, in daily dose or treatment duration, prescribed at surgical discharge.

Methods: A systematic search of MEDLINE, EMBASE, CENTRAL, and ICTRP was performed from inception to 12 January 2025.

Cost savings of reducing opioid prescribing for the treatment of people with low back pain in general practice: a modelling study.

Background: Low back pain (LBP) is the leading cause of disability worldwide. Contrary to clinical guidelines, opioids are frequently prescribed early in the management of LBP in primary care, leading to potential harm and downstream healthcare costs. The objective of this study was to model the one-year impacts of strategies that reduce opioid prescribing for low back pain (LBP) in primary care on healthcare costs and overdose deaths Australia-wide and explore the potential for such strategies to be cost-neutral.

DREAM: an adaptive, randomised, placebo-controlled trial of duloxetine for reducing leg pain in people with chronic sciatica-trial protocol.

Introduction: Sciatica is a debilitating condition that often becomes chronic, and for which there are few effective treatment options. Treatments such as the anti-depressant duloxetine have shown promise, but the evidence is inconclusive. We are describing a high quality, definitive trial to investigate the efficacy, safety and cost-effectiveness of duloxetine in chronic sciatica.

Implementability of opioid deprescribing interventions at transitions of care: A scoping review.

Continuation of opioids at transitions of care increases the risk of long-term opioid use and related harm. To our knowledge, no study has examined the implementability of opioid deprescribing interventions at transitions of care. Our scoping review aimed to identify the type of opioid deprescribing interventions employed at transitions of care and assess the implementability of tested interventions.

Effectiveness of Interventions to Reduce Opioid Use After Orthopaedic Surgery: A Systematic Review of Randomised Controlled Trials.

Background: The prescribing of opioids to patients for postoperative pain can lead to persistent opioid use. This review investigated the effectiveness of interventions aimed at reducing opioid use in patients after orthopaedic surgery.

Methods: Electronic databases were searched from inception to November 2023.

Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials.

Background: International low back pain guidelines recommend providing education/advice to patients, discouraging routine imaging use, and encouraging judicious prescribing of analgesics. However, practice variation occurs and the effectiveness of implementation strategies to promote guideline-concordant care is unclear. This review aims to comprehensively evaluate the effectiveness of implementation strategies to promote guideline-concordant care for low back pain.

The brief pain inventory-Interference Subscale has acceptable reliability but questionable validity in acute back and neck pain populations.

Background: The Brief Pain Inventory-Interference Subscale (BPI-IS) is a subscale of the BPI assessment tool developed to rapidly assess the impact of a person's pain on their function. It is uncertain whether it has one or two factors, and whether it has acceptable clinimetric properties in a mixed spinal pain (back and/or neck) population.

Objectives: To determine the clinimetric properties of the BPI-IS in a population with mixed spinal pain.

Rehabilitation for ankle fractures in adults.

Background: Ankle fracture is one of the most common lower limb fractures. Whilst immobilisation of the ankle can support and protect the fracture site during early healing, this also increases the risk of ankle weakness, stiffness, and residual pain. Rehabilitation aims to address the after-effects of this injury, to improve ankle function and quality of life.

Paracetamol Combination Therapy for Back Pain and Osteoarthritis: A Systematic Review and Meta-Analyses.

Background And Objective: Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis.

Methods: Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis.

How is postoperative pain after hip and knee replacement managed? An analysis of two large hospitals in Australia.

Background: Multimodal analgesia regimens are recommended for the postoperative period after hip and knee replacement surgeries. However, there are no data on practice patterns for analgesic use in the immediate postoperative period after hip and knee replacements in Australia.

Objectives: To describe analgesic prescribing patterns in the inpatient postoperative phase for patients undergoing hip and knee replacement.

Compliance with Australian Orthopaedic Association guidelines does not reduce the risk of venous thromboembolism after total hip and knee arthroplasty.

Preventing avoidable venous-thrombo-embolism (VTE) is a priority to improve patient and service outcomes after total hip and total knee arthroplasty (THA, TKA), but compliance with relevant clinical guidelines varies. This study aims to determine the degree to which prophylaxis was compliant with Australian Orthopaedic Association (AOA) VTE prophylaxis guidelines and whether non-compliance is associated with increased risk of VTE. A prospective multi-centre cohort study of adults with osteoarthritis undergoing primary TKA/THA was completed at 19 high-volume public and private hospitals.

Opioids for Acute Musculoskeletal Pain: A Systematic Review with Meta-Analysis.

Objective: To evaluate the efficacy of opioids for people with acute musculoskeletal pain against placebo.

Study Design: Systematic review and meta-analyses of randomised, placebo-controlled trials of opioid analgesics for acute musculoskeletal pain in any setting. The primary outcomes were pain and disability at the immediate timepoint (< 24 h).

Context matters: using an Evidence to Decision (EtD) framework to develop and encourage uptake of opioid deprescribing guideline recommendations at the point-of-care.

Objectives: To describe the development and use of an Evidence to Decision (EtD) framework when formulating recommendations for the Evidence-Based Clinical Practice Guideline for Deprescribing Opioid Analgesics.

Study Design And Setting: Evidence was derived from an overview of systematic reviews and qualitative studies conducted with healthcare professionals and people who take opioids for pain. A multidisciplinary guideline development group conducted extensive EtD framework review and iterative refinement to ensure that guideline recommendations captured contextual factors relevant to the guideline target setting and audience.

Understanding general practitioners' prescribing choices to patients with chronic low back pain: a discrete choice experiment.

Background: Although NSAIDs are recommended as a first line analgesic treatment, opioids are very commonly prescribed to patients with low back pain (LBP) despite risks of harms.

Aim: This study aimed to determine factors contributing to general practitioners' (GPs') prescribing choices to patients with chronic LBP in a primary care setting.

Method: This discrete choice experiment (DCE) presented 210 GPs with hypothetical scenarios of a patient with chronic LBP.

Continued Opioid Use and Adverse Events Following Provision of Opioids for Musculoskeletal Pain in the Emergency Department: A Systematic Review and Meta-Analysis.

Background: The prevalence of continued opioid use or serious adverse events (SAEs) following opioid therapy in the emergency department (ED) for musculoskeletal pain is unclear. The aim of this review was to examine the prevalence of continued opioid use and serious adverse events (SAEs) following the provision of opioids for musculoskeletal pain in the emergency department (ED) or at discharge.

Methods: Records were searched from MEDLINE, EMBASE and CINAHL from inception to 7 October 2022.