Low Back Pain Presentation and Management at the Emergency Department: Differences Between Older Adults Residing in the Community and Aged Care Homes

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-04-11 DOI:10.1111/jep.70088

Rod Ellem, Quinn Burling, Michel W. Coppieters, James Todd, Rowan Pickering

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引用次数: 0

Abstract

Rationale

In healthcare systems without gatekeeper access to Emergency Departments (ED), the number of people presenting for low back pain (LBP) is increasing substantially. Low back pain presentations at the Emergency Department are rarely caused by serious underlying pathology, and management often deviates from practice guidelines. Older adults (≥ 65 years) constitute approximately 30% of all ED LBP presentations. Little is known about differences in presentation characteristics and ED management between older adults from aged care homes and those living in the community.

Aims and Objectives

This study aimed to identify differences in presentation and management between people presenting at the ED for LBP from aged care homes versus those residing in the community.

Methods

Retrospective observational study of routinely collected healthcare data and chart audits of older adults from aged care homes (N = 64) and age and sex-matched community-dwelling older adults (N = 64) presenting to ED for LBP.

Results

Patients from aged care homes presented with more comorbidities (4 vs. 2), analgesic medication (84% vs. 70%) and polypharmacy (86% vs. 41%) and were more commonly admitted for ongoing analgesia or further diagnostic tests. Community-dwelling older adults were more frequently admitted for Allied Health input. ED administration of opiates was high for both groups (81% aged care; 91% community-dwelling). High rates of lumbar spine medical imaging (61% aged care; 50% community-dwelling) resulted in few acute radiographic findings.

Conclusions

Older patients presenting to ED for LBP receive similar management regardless of their residential status. Hospital management of both groups does not align with current published recommendations namely in respect to imaging and pain medication.

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.