Background: Back pain accounts for approximately 4% of all Emergency Department (ED) presentations in Ireland and internationally. Patients with back pain presenting to ED tend to be in “crisis”, reporting high pain scores, making it complex to triage and manage in ED, resulting in management inconsistent with guideline recommendations. Previous international research has reported liberal prescribing of opioids, high imaging and inpatient admission rates for patients with non-serious low back pain attending ED. No study has previously investigated the patient experience time or management of people with back pain attending the ED in Ireland.
Objective: This multi-centre retrospective study will investigate patient experience time, diagnosis and management of people with back pain attending the ED of five large urban hospitals.
Methods: Consecutive patients attending the ED of five Dublin Academic Teaching Hospitals in May 2023 for back pain assessment will be included. The following data will be extracted from the ED clinical notes and hospital information systems using a standardised data extraction tool: Age, gender, insurance status), ED arrival information, time of ED attendance and triage assessment, triage status and acuity scale, time of consultation with ED clinician, professional background of ED clinician, total patient experience time (PET), time of investigation, ED discharge time and destination, back pain diagnosis, ED management (medications prescribed, investigations, referral to physiotherapy or other specialties), documented advice, documented safety netting. Statistical analysis: All data will be analysed in STATA v16.0 statistical software and summary results presented as means and standard deviations (continuous data), and frequency statistics (categorical data). Results will be compared across sites, using analysis of variance and chi-squared tests. Research relevance: With ongoing pressures in Irish public hospital EDs, this multisite study will add important information on back pain management within this setting, and whether management is consistent with best practice recommendations.
