{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:19:48Z","timestamp":1787743188375,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low back pain (LBP) is a common reason for presentation to an emergency department (ED) but LBP\u2010care in this setting is frequently low\u2010value, costly and often fails to meet system and patient needs. Other service options are urgently required. This study evaluated a novel care pathway that diverted people with suspected non\u2010serious LBP seeking ED\u2010care to a community\u2010based, hospital avoidance service in a large South Australian health network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective quantitative analysis was conducted on data extracted from electronic medical records (demographics, service activity, subsequent presentations\/admissions) for patients seen March\u2013December 2024, and analyzed using descriptive statistics. Repeated measures analysis of selected EQ\u20105D\u20105L items (pain\/discomfort, usual activities, anxiety\/depression) was conducted using the Wilcoxon signed\u2010rank test. Semi\u2010structured interviews undertaken May\u2010Nov 2024 with consecutive eligible patients explored experiences of care via qualitative thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 143 patients (mean age\u2009=\u200952.1\u2009years, SD\u2009=\u200919.0) managed via this pathway. All received multidisciplinary care and 101 (78%) registered for digitally supported follow\u2010up. Patients reported significant improvements in pain\/discomfort and usual activities (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) 2\u2010weeks following initial evaluation, but not anxiety\/depression. Most patients (90%) did not present to a public hospital ED within 90\u2009days of intervention. Interviews (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) identified four key themes: faster access and reducing ED pressure, care that meets expectations, digitally supported care assists recovery, and recommendations for improvements in LBP\u2010care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This digitally supported hospital avoidance pathway provided an acceptable alternative to ED\u2010care for patients with LBP with potential to offer significant benefits to the health system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70395","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:43:29Z","timestamp":1786682609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Hospital Avoidance Pathway With Digitally Supported Follow\u2010Up for Low Back Pain: An Alternative to Emergency Department Care"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9908-2135","authenticated-orcid":false,"given":"Joseph F.","family":"Orlando","sequence":"first","affiliation":[{"name":"IIMPACT in Health, Allied Health and Human Performance, College of Health Adelaide University  Adelaide South Australia Australia"},{"name":"Central Adelaide Local Health Network, SA Health  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Zucco","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network, SA Health  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network, SA Health  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0109-2950","authenticated-orcid":false,"given":"Anne L. J.","family":"Burke","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network, SA Health  Adelaide South Australia Australia"},{"name":"Commission on Excellence and Innovation in Health, Government of South Australia  Adelaide South Australia Australia"},{"name":"School of Psychology, College of Education, Behavioural and Social Sciences Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9679-7284","authenticated-orcid":false,"given":"Matthew","family":"Beard","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network, SA Health  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Guerin","sequence":"additional","affiliation":[{"name":"IIMPACT in Health, Allied Health and Human Performance, College of Health Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-4411","authenticated-orcid":false,"given":"Saravana","family":"Kumar","sequence":"additional","affiliation":[{"name":"IIMPACT in Health, Allied Health and Human Performance, College of Health Adelaide University  Adelaide South Australia 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