Researchers in Australia have successfully completed the SHAPED  (Sydney Health Partners Emergency Department)  trial, a pivotal study aimed at reducing opioid dispensing in emergency room settings without increasing reliance on other high-risk medications. The trial, conducted by teams from institutions such as Laval University and the University of Sydney, showcased a 12.3% reduction in opioid dispensing following a guideline training intervention.

Detailed in a research letter titled “Shifting From Opioids to Simple Analgesics for Emergency Care of Patients With Low Back Pain,” published in the JAMA Health Forum, the trial aligns with global efforts to mitigate opioid use by promoting NSAIDs and paracetamol as first-line treatments. Historically, opioids have been over-prescribed for lower back pain, with nearly two-thirds of such patients in Australian emergency rooms receiving opioids, contrasted with about 40% in the United States.

During the SHAPED trial, opioid dispensing for lower back pain declined from 62.8% to 50.5%. Crucially, there was no significant increase in the use of other risky medications like benzodiazepines. Instead, the use of NSAIDs alone rose by 1.4%, and the combination of NSAIDs with paracetamol increased by 7.1%. The trial also recorded a 2.3% decrease in benzodiazepine use, further underscoring the effectiveness of the intervention.

The SHAPED trial shows that we can cut back on opioid use without turning to other risky drugs. By using safer options like NSAIDs and paracetamol, hospitals can manage pain more safely.

The SHAPED trial’s findings represent a promising advancement in safer pain management strategies, advocating for adherence to evidence-based guidelines. The shift towards NSAIDs and paracetamol not only aligns with efforts to address the opioid crisis but also highlights the importance of implementing guideline-based training interventions. Researchers emphasise the need for further studies to explore how these successful strategies can be scaled and adapted to other healthcare settings globally.

Source: Medical X press