Authored by the Australian Commission on Safety and Quality in Health Care with medical journalist Nicole MacKee
Action on low back pain Push to reduce interventions, improve management
Moves to improve the management of low back pain in Australia are gaining momentum with a national clinical care standard under development and an initiative to reduce inappropriate care in emergency departments. An estimated 70-90% of Australians will experience low back pain at some stage in their lives, but many will receive care — including imaging, opioids and surgery — that is at odds with evidence-based guidelines.1 And it’s not just a local problem. In 2018, The Lancet published a series of articles calling for improved management globally. To improve care, the Australian Commission on Safety and Quality in Health Care is developing a Low Back Pain Clinical Care Standard. The draft Standard was recently open for consultation and is expected to be finalised later this year. 38
The Health Advocate • MAY 2021
Atlas findings The urgent need for clinical guidance on low back pain management was reinforced last month with the release of the Fourth Australian Atlas of Healthcare Variation. The Atlas examines surgery for lumbar spinal decompression and lumbar spinal fusion. These surgical operations have a limited role in treating chronic low back pain (spinal surgery for treating infection, tumours, or injury, was excluded from examination in the Atlas). The Atlas shows that in 2015–2018, the rate of hospitalisation for lumbar spinal fusion was 12.4 times as high in the area with the highest rate compared with the area with the lowest rate. For lumbar spinal decompression, the rate of hospitalisation in the area with the highest rates was 7.7 times the area with the lowest. The Atlas did note, however, that there was
