{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:42:13Z","timestamp":1781970133210,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Patients with low back pain (LBP) are often treated with nonsteroidal anti\u2010inflammatory drugs (NSAIDs). NSAIDs are modestly effective for LBP, but many patients with LBP continue to suffer despite treatment with these medications. We compared pain and functional outcomes 1 week after emergency department (ED) discharge among patients randomized to a 1\u2010week course of ibuprofen plus acetaminophen versus ibuprofen plus placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized, double\u2010blind study conducted in two urban EDs. Patients presenting with acute, nontraumatic, nonradicular LBP of no more than 2\u00a0weeks\u2019 duration were eligible for enrollment immediately prior to discharge from an ED if they had a score\u00a0&gt;\u00a05 on the Roland Morris Disability Questionnaire (RMDQ), a 24\u2010item validated instrument, indicating more than minimal functional impairment. All patients were given a standardized 10\u2010minute LBP educational session prior to discharge. The primary outcome was improvement on the RMDQ between ED discharge and 1 week later. One secondary outcome was pain intensity, as measured on a 4\u2010point descriptive scale (severe, moderate, mild, none) at 1 week.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Enrollment began in October 2018. A total of 120 patients met selection criteria and were randomized. Baseline demographic characteristics were comparable between the two groups. By 1 week after the ED visit, patients randomized to ibuprofen plus placebo reported a mean (\u00b1SD) improvement in the RMDQ of 11.9 (\u00b19.7), while those randomized to ibuprofen plus acetaminophen reported a mean (\u00b1SD) improvement of 11.1 (\u00b110.7). The 95% CI for the between\u2010group difference of 0.8 was \u22123.0 to 4.7. At 1 week, moderate or severe pain was reported by 15 of 53 (28%) patients in the ibuprofen plus placebo group and 16 of 57 (28%) patients in the ibuprofen plus acetaminophen group (95% CI for between\u2010group difference of 0%\u00a0= \u221217% to 17%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among ED patients with acute, nontraumatic, nonradicular LBP, adding acetaminophen to ibuprofen does not improve outcomes within 1 week.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13898","type":"journal-article","created":{"date-parts":[[2019,12,7]],"date-time":"2019-12-07T07:53:04Z","timestamp":1575705184000},"page":"229-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Ibuprofen Plus Acetaminophen Versus Ibuprofen Alone for Acute Low Back Pain: An Emergency Department\u2013based Randomized Study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2753-5860","authenticated-orcid":false,"given":"Benjamin W.","family":"Friedman","sequence":"first","affiliation":[{"name":"From the Department of Emergency Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddie","family":"Irizarry","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Chertoff","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Feliciano","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemencia","family":"Solorzano","sequence":"additional","affiliation":[{"name":"and the Department of Pharmacy Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftheria","family":"Zias","sequence":"additional","affiliation":[{"name":"and the Department of Pharmacy Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. John","family":"Gallagher","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181d952a5"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.09.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13043"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2367"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2016.10.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.09.031"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.02.017"},{"key":"e_1_2_8_9_1","first-page":"CD012230","article-title":"Paracetamol for low back pain","author":"Saragiotto BT","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012150-00006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31815e3a10"},{"key":"e_1_2_8_12_1","first-page":"18","article-title":"Ibuprofen plus paracetamol versus ibuprofen in acute low back pain: a randomized open label multicenter clinical study","volume":"42","author":"Ostojic P","year":"2017","journal-title":"Acta Reumatol Port"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.08.041"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.06.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2005.01.023"},{"key":"e_1_2_8_16_1","first-page":"CD000396","article-title":"Non\u2010steroidal anti\u2010inflammatory drugs for low back pain","author":"Roelofs PD","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2016.10.001"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13453"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60937-9"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.13898","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.13898","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.13898","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.13898","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T23:29:40Z","timestamp":1694042980000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.13898"}},"subtitle":[],"editor":[{"given":"Shellie","family":"Asher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,1,7]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1111\/acem.13898"],"URL":"https:\/\/doi.org\/10.1111\/acem.13898","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,7]]},"assertion":[{"value":"2019-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}