Research Translation Project Receives $4.8 million to Tackle Opioid Overuse in EDs

The SMART-ED trial, which will involve up to 44 emergency departments and 8,800 patients across New South Wales, will test optimal implementation strategies of back pain guidelines.

It’s the latest step in the wider implementation and scale-up of an intervention which was originally seed-funded by Sydney Health Partners in 2016.

That trial, called SHaPED, was run in four EDs at Sydney Local Health District and Dubbo Health Service, and significantly reduced the rate of opioid prescriptions for acute back pain by encouraging clinicians to adopt evidence-based clinical guidelines that recommend patients receive non-pharmacological treatments in the first instance.

The trial won the 2022 Clinical Trial of the Year award from the Australia and New Zealand Musculoskeletal Clinical Trials Network.

The MRFF grant for SMART-ED has been awarded to Associate Professor Gustavo Machado, who is an NHMRC Principal Research Fellow at the Institute for Musculoskeletal Health in the Sydney Local Health District and the University of Sydney.

He says the study will be the largest of its kind to investigate the most effective ways to implement evidence-based back pain guidelines in the emergency setting.

“This funding is a game-changer and builds on nearly a decade of research aimed at improving the care of people with back pain in emergency departments,” said Associate Professor Machado.

“Back pain is the sixth most common reason people present to EDs, but despite clear evidence that opioid pain killers are often not effective for this condition and carry significant risks, many patients continue to be administered and prescribed opioids,”

The Executive Director of Sydney Health Partners, Professor Don Nutbeam, congratulated Associate Professor Machado and his team on the grant.

“This is extraordinarily important work and exemplifies the kind of translational research and research translation that we are all working for.”

The study will use an implementation science approach to test several strategies to reduce overprescription of opioid medicines, such as staff education, audit and feedback processes, and opioid sparing interventions.

The findings will inform national policy and practice, aiming to improve outcomes for the millions of Australians affected by back pain.

“Our goal is to shift the culture around back pain management amongst emergency clinicians, ensuring that patients receive safe, effective, and evidence-based care, without unnecessary exposure to opioids,” said Associate Professor Machado.