Usual Care for Low Back Pain at United States Emergency Departments, 2016-2022.

Study Objectives: Low back pain is a common reason for visiting the emergency department (ED). Updated and reliable national estimates of usual care for low back pain are needed to identify research and quality improvement priorities to improve patient outcomes and reduce low-value emergency care.

Methods: This is a cross-sectional study of the National Hospital Ambulatory Medical Care Survey from 2016 to 2022.

Application of Algorithm-Based Treatment Approach to Low Back Pain in the Emergency Department.

Low back pain accounts for nearly 4 million annual emergency department (ED) visits, and patient outcomes following an ED visit for low back pain are poor. Additionally, only a small portion of patients visiting the ED for low back pain follow up with outpatient physical therapy within 3 months, despite established benefits of early versus delayed physical therapy referral such as improved patient outcomes, less opioid use, and reduced downstream health care utilization. Integrating a physical therapist directly into the ED care team can facilitate evidence-based guideline concordant care and improve patient outcomes, however, physical therapists who are staffed into this role from other settings may lack experience with evaluating and managing patients with acute low back pain.

Emergency Department Vestibular Rehabilitation Therapy for Dizziness and Vertigo: A Nonrandomized Clinical Trial.

Importance: Dizziness symptoms account for nearly 2 million annual emergency department (ED) visits and present a diagnostic challenge for clinicians. Most dizziness research has focused on improving guideline-concordant care among clinicians, with little focus on developing patient-centered interventions to improve dizziness-related disability.

Objective: To examine the feasibility of ED vestibular rehabilitation therapy (ED-VeRT) using a protocolized diagnostic classification algorithm and collection of longitudinal patient-reported outcomes.

Patient Perspectives on Seeking Emergency Care for Acute Low Back Pain and Access to Physical Therapy in the Emergency Department.

Study Objective: Low back pain is a common reason for visiting the emergency department (ED), yet little is known about patient motivations for seeking emergency care. The purpose of this study was to explore patient perspectives on visiting the ED for low back pain to inform a more patient-centered approach to emergency care.

Methods: We conducted focus group discussions and individual interviews among patients visiting an urban academic ED for acute low back pain.

Unintentional Opioid Overdose Death Characteristics in Illinois Before and During the COVID-19 Era, 2017 to 2020.

This cross-sectional study characterizes Illinois unintentional opioid overdose deaths from July 2017 through June 2020 using data from the Centers for Disease Control and Prevention State Unintentional Drug Overdose Reporting System.

Feasibility of Emergency Department-based Fentanyl Test Strip Distribution.

Objectives: United States drug overdose deaths now overwhelmingly involve fentanyl and fentanyl analogs. The emergency department (ED) is an important setting to provide harm reduction for persons who use drugs, but ED-based fentanyl test strip distribution has not yet been described.

Methods: This is an observational study of patients with an opioid-related visit to an ED in downtown Chicago, Illinois.

Impact of the COVID pandemic on emergency department CT utilization: where do we go from here?

Purpose: To analyze the impact of the coronavirus disease (COVID) pandemic on emergency department (ED) computed tomography (CT) utilization.

Methods: A retrospective observational study was conducted assessing seven hospitals' ED imaging volumes between Jan. 6, 2019, and Feb.

Antibiotic and antitussive prescribing among urgent care and emergency department visits for respiratory diagnoses in a large health system.

Objective: Urgent care centers (UCs) commonly evaluate patients with respiratory infections, and patients increasingly prefer UCs to emergency departments (EDs) because of their customer-centric approach. The aim of this study is to describe antibiotic and opioid prescribing among UC and ED visits with respiratory diagnoses.

Methods: This is a cross-sectional study of visits to 7 EDs and 6 UCs in the greater Chicago area.

Embedded emergency department physical therapy versus usual care for acute low back pain: a protocol for the NEED-PT randomised trial.

Introduction: Low back pain is a common problem and a substantial source of morbidity and disability worldwide. Patients frequently visit the emergency department (ED) for low back pain, but many experience persistent symptoms at 3 months despite frequent receipt of opioids. Although physical therapy interventions have been demonstrated to improve patient functioning in the outpatient setting, no randomised trial has yet to evaluate physical therapy in the ED setting.

Disparities by Sex and Race and Ethnicity in Death Rates Due to Opioid Overdose Among Adults 55 Years or Older, 1999 to 2019.

Importance: Rates of opioid overdose deaths are increasing for older adults. Less is known about these deaths compared with those of younger adults.

Objective: To analyze rate variation among opioid overdose deaths in older adults by sex and by race and ethnicity over time.

Opioid-related Emergency Department Visits During COVID-19 in a Large Health System.

Objective: Multiple states have reported increases in opioid overdose deaths during the coronavirus disease 2019 (COVID-19) pandemic, however little is known about opioid-related presentations to the emergency department (ED).

Methods: This was a time series analysis of visits to 7 EDs in greater Chicago, Illinois from October 20, 2019 to July 25, 2020. We compared the number of ED visits for opioid-related diagnoses in the time period preceding the World Health Organization pandemic declaration (prepandemic period, October 20, 2019-July 3, 2020) to the time period following the World Health Organization declaration (pandemic period, March 8, 2020 to July 25, 2020) using a single-group interrupted time series analysis with Newey-West standard errors.

Perceptions of Signs of Addiction Among Opioid Naive Patients Prescribed Opioids in the Emergency Department.

Objectives: Patient knowledge deficits related to opioid risks, including lack of knowledge regarding addiction, are well documented. Our objective was to characterize patients' perceptions of signs of addiction.

Methods: This study utilized data obtained as part of a larger interventional trial.

Take-Home Naloxone and the Need for a Publicly Funded Naloxone Supply.

The opioid crisis continues to exact a heavy toll on the United States, and overdose deaths have only increased during the current global pandemic. One effective intervention to reduce overdose deaths is to distribute the opioid antagonist naloxone directly to persons actively using opioids (ie, "take-home naloxone"), especially at touchpoints with the potential for significant impact such as emergency departments and jails. A number of hospital emergency departments have recently sought to implement individual take-home naloxone programs; however, programmatic success has been inconsistent due primarily to the inability to secure reliable funding for a naloxone supply.

A Prospective Observational Study of Emergency Department-Initiated Physical Therapy for Acute Low Back Pain.

Objective: Low back pain accounts for nearly 4 million emergency department (ED) visits annually and is a significant source of disability. Physical therapy has been suggested as a potentially effective nonopioid treatment for low back pain; however, no studies to our knowledge have yet evaluated the emerging resource of ED-initiated physical therapy. The study objective was to compare patient-reported outcomes in patients receiving ED-initiated physical therapy and patients receiving usual care for acute low back pain.

Development of a take-home naloxone program at an urban academic emergency department.

Objective: To describe the development of an ED-based take-home naloxone (THN) program in which naloxone kits are dispensed directly to patients during ED discharge.

Practice Description: Our THN program was carried out at an urban academic hospital in downtown Chicago, IL. The THN kits consisted of 3 vials of 0.

Take-Home Naloxone Program Implementation: Lessons Learned From Seven Chicago-Area Hospitals.

Despite consensus recommendations from the American College of Emergency Physicians (ACEP), the Centers for Disease Control and Prevention, and the surgeon general to dispense naloxone to discharged ED patients at risk for opioid overdose, there remain numerous logistic, financial, and administrative barriers to implementing "take-home naloxone" programs at individual hospitals. This article describes the recent collective experience of 7 Chicago-area hospitals in implementing take-home naloxone programs. We highlight key barriers, such as hesitancy from hospital administrators, lack of familiarity with relevant rules and regulations in regard to medication dispensing, and inability to secure a supply of naloxone for dispensing.

Patient-Reported Opioid Pill Consumption After an ED Visit: How Many Pills Are People Using?

Objectives: Recent guidelines advise limiting opioid prescriptions for acute pain to a three-day supply; however, scant literature quantifies opioid use patterns after an emergency department (ED) visit. We sought to describe opioid consumption patterns after an ED visit for acute pain.

Design: Descriptive study with data derived from a larger interventional study promoting safe opioid use after ED discharge.