Physiotherapists prescribing medications to manage pain in emergency departments and outpatient clinics
In patients presenting to emergency departments or orthopaedic clinics with musculoskeletal conditions, does physiotherapists prescribing medications to manage pain result in adverse events?
QEII Jubilee Hospital
2,500 participants
May 11, 2017
Interventional
Conditions
Summary
This study aims to investigate the safety and patient experience of prescribing by credentialed physiotherapists. Patients attending emergency departments and outpatient clinics with musculoskeletal conditions will be prescribed medications from a limited list to manage pain and support physiotherapy treatment.
Eligibility
Inclusion Criteria5
- Male or female aged 18 years and over
- There is a requirement to prescribe medication to the extent necessary for the physiotherapist to practice physiotherapy,
- Peripheral musculoskeletal injuries / conditions / symptoms: sprains, strains, suspected simple fractures, subacute and chronic tendinitis, tendinosis, tenosynovitis, bursitis, tenovaginitis (trigger finger, DeQuervain’s) and osteoarthritic arthritic joint disease OR Musculoskeletal pain of spinal origin
- Ability to provide informed consent and accurately follow the instructions of the researcher
- Attending emergency department or outpatient clinics for the management of their musculoskeletal condition
Exclusion Criteria15
- Open wounds
- Infection
- Active Inflammatory disease as the primary reason for intervention (i.e. rheumatoid disease and the seronegative arthritides)
- Neoplastic disease as the primary reason for intervention
- Cardiovascular disease as the primary reason for intervention
- Metabolic disease as the primary reason for intervention
- Central nervous system disorders as the primary reason for intervention
- Cauda equina injury
- Acute head injury
- Loss or altered state of consciousness
- Pain of non-mechanical origin
- Polytrauma and high energy injuries including falls from above standing height
- Respiratory distress
- Abdominal pain
- Women who are pregnant and the human foetus
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Interventions
Assessment and management of patient presentation in accordance with clinical guidelines by physiotherapists in the emergency department or orthopaedic clinic. This may involve mobilisation, massage, exercise therapy, stretches, advice and provision of the following medications, at the discretion of the physiotherapist, for the management of pain: Paracetamol (oral tablet) Paracetamol and Codeine (oral tablet) Diclofenac sodium (oral tablet) Lignocaine 1 or 2% (subcutaneous or intra-articular injection) Nitrous Oxide up to 70% (inhaled gas) Ibuprofen (oral tablet) Betamethasone injection 5.7mg/ml (intra-articular injection) Methylprednisolone acetate 40mg/ml 1ml (intra-articular injection) Amitriptyline hydrochloride (oral tablet)
Locations(5)
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ACTRN12615000525583