Use of and attitudes to the role of medication for acute whiplash injury: A preliminary survey of emergency department doctors

Emerg Med Australas. 2019 Jun;31(3):471-474. doi: 10.1111/1742-6723.13190. Epub 2018 Oct 14.

Abstract

Objective: Describe current practice of medication prescribing for acute whiplash-associated disorders (WAD) in the ED and explore attitudes towards pregabalin prescription for WAD.

Methods: Questionnaire-based survey in two EDs collected data on demographics and self-reported medication prescribing for WAD. Comfort in various scenarios for pregabalin prescribing was rated.

Results: A total of 145/170 (85%) doctors responded; 42.8% were junior doctors. Self-reported medications prescribed were nonsteroidal anti-inflammatory drug (77.9% [95% confidence interval (CI) 70.1-84.2]), paracetamol (75.2% [95% CI 67.2-81.8]), opioids (43.5% [95% CI 35.3-51.9]) and benzodiazepines (11.0% [95% CI 6.6-17.6]). Most were comfortable to prescribe pregabalin in evidence-based or advised-by-specialists scenarios.

Conclusions: Opioids appear to be over-prescribed. Further research into pregabalin prescription in ED is warranted.

Keywords: motor vehicle crash; pain; pregabalin; prescribing; whiplash-associated disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / therapeutic use
  • Adult
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Attitude of Health Personnel
  • Benzodiazepines / therapeutic use
  • Emergency Medicine / methods
  • Emergency Medicine / standards
  • Female
  • Humans
  • Male
  • Physicians / psychology*
  • Physicians / standards
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends
  • Queensland
  • Surveys and Questionnaires
  • Whiplash Injuries / drug therapy*

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Benzodiazepines
  • Acetaminophen