top of page
AdobeStock_158913547_test treatments.jpeg

Testing Treatments

When patients seek treatment, they want an intervention that helps them get better (effective), has minimal or manageable side effects (safe), and justifies the money they spend (cost-effective). Providing effective, safe and cost-effective treatments is important to clinicians, health funders and patients. In the Intervention Testing theme, we rigorously evaluate whether treatments are effective, safe and cost-effective to continuously improve the care that patients receive.

​

Our research has improved the management of musculoskeletal conditions. For example, we have found that for people with certain injuries (chronic whiplash or ankle fracture), simple advice from the physiotherapist is just as effective as a structured exercise program. We have also found that some medicines – such as pregabalin – are not effective and may be harmful in back pain conditions, and this has changed the way these medicines are being recommended in practice.

​

The Testing Treatments theme includes research staff, research students and professional staff from a variety of backgrounds including physiotherapy and pharmacy.

Theme Leader

Current research projects & trials

This project aims to investigate the effects of oral glucocorticoids in people with acute sciatica. There is currently no simple, effective treatment to relieve the pain in acute sciatica. Acute sciatica is a prevalent, debilitating pain condition. Preliminary evidence suggests that taking oral glucocorticoids may relieve pain and improve function in acute sciatica. The OASIS clinical trial will evaluate whether oral glucocorticoids are effective and safe compared to placebo. The medication will be taken for up to 2 weeks. Participants will be followed up for one year to measure leg pain intensity and other important outcomes. We will also assess drug safety and evaluate cost-effectiveness. This trial is now recruiting. The research team is also looking for General Practitioners who are interested in research to be involved with the recruitment of patients with sciatica into the OASIS study. For more information, please contact: Giovanni Ferreira e: giovanni.ferreira@sydney.edu.au The sponsor of this trial is The University of Sydney. OASIS is funded by the National Health and Medical Research Council. Principal Investigator: Professor Christine Lin (IMH) Chief Investigators: Professor Andrew McLachlan (University of Sydney), Professor Jane Latimer (IMH), Dr Christina Abdel Shaheed (IMH), Qiang Li (The George Institute) Associate Investigators: Dr Bethan Richards (IMH), Professor Rachelle Buchbinder (Monash University), Professor Chris Maher (IMH), Professor Ric Day (University of NSW).

Low back pain affects 1 in 4 Australians and is a leading cause for opioid analgesic prescriptions globally. The COMFORT trial aims to support general practitioners to provide opioid stewardship for patients with low back pain. The trial will compare two ways of prescribing an opioid analgesic. The first is the traditional way GPs carefully prescribe the medicine in usual care. The second offers patients other pain relief options in addition to the opioid analgesic. We are not sure which way works best. If successful, the COMFORT trial has the potential to transform care for people with low back pain globally.

EPIK will investigate the effectiveness, cost-effectiveness, and safety of a model of care to manage patients with persistent pain after total knee replacement (TKR). TKR is used to treat severe osteoarthritis & is one of the most common & expensive procedures performed in Australia. There is no established model of care to effectively manage patients with persistent pain after TKR in Australia, which affect up to 25% of those who undergo TKR. Many of these patients slip through the cracks & are left without options. We propose a new model of care (EPIK) to address this unmet need. EPIK combines i) routinely collected data from a national joint registry which will act as a 'safety net' for patients with persistent pain following TKR; and ii) early assessment and care coordination by a physiotherapist to ensure patients get the right care at the right time.

This project aims to investigate the effects of oral glucocorticoids in people with acute sciatica. There is currently no simple, effective treatment to relieve the pain in acute sciatica. Acute sciatica is a prevalent, debilitating pain condition. Preliminary evidence suggests that taking oral glucocorticoids may relieve pain and improve function in acute sciatica. The OASIS clinical trial will evaluate whether oral glucocorticoids are effective and safe compared to placebo. The medication will be taken for up to 2 weeks. Participants will be followed up for one year to measure leg pain intensity and other important outcomes. We will also assess drug safety and evaluate cost-effectiveness. This trial is now recruiting. The research team is also looking for General Practitioners who are interested in research to be involved with the recruitment of patients with sciatica into the OASIS study. For more information, please contact: Giovanni Ferreira e: giovanni.ferreira@sydney.edu.au The sponsor of this trial is The University of Sydney. OASIS is funded by the National Health and Medical Research Council. Principal Investigator: Professor Christine Lin (IMH) Chief Investigators: Professor Andrew McLachlan (University of Sydney), Professor Jane Latimer (IMH), Dr Christina Abdel Shaheed (IMH), Qiang Li (The George Institute) Associate Investigators: Dr Bethan Richards (IMH), Professor Rachelle Buchbinder (Monash University), Professor Chris Maher (IMH), Professor Ric Day (University of NSW).

Repairs Pilot Trial

Testing the feasibility and acceptability of a trial to investigate whether a reduced amount of opioids prescribed upon discharge after total hip and knee replacement is as effective as a standard amount.

OPAL

The OPAL trial, led by the University of Sydney, is a world-first placebo-controlled study investigating the effectiveness of opioids for acute spinal pain. Despite widespread opioid prescriptions for back and neck pain, there is limited evidence supporting their benefits. The trial recruited nearly 350 participants from primary care and emergency departments, randomly assigning them to a six-week course of either opioids or a placebo. Results showed opioids were no more effective than placebo for pain relief, and those taking opioids had a higher risk of misuse after 12 months. Researchers concluded that opioids should not be recommended for acute spinal pain, even as a last resort. The study provides critical evidence to update treatment guidelines and reduce unnecessary opioid prescriptions. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/abstract

Resolve-D

RESOLVE-D aims to accelerate the research translation of graded sensorimotor retraining, a new therapeutic intervention for chronic low back pain. The project team are partnering with Noigroup, an industry leading clinical education provider, to develop a clinician training package for graded sensorimotor retraining, test whether it produces better outcomes than best practice care and evaluate implementation in clinical practice. RESOLVE-D will deliver clinician and patient materials that have been refined to ensure commercial viability and optimised for superior user experience.

WALKBACK - Effectiveness and cost-effectiveness of a progressive individualised walking and education program for the prevention of a recurrence of low back pain

The intention of the trial was to prevent recurrences of low back pain through determining if a progressive individualised walking and education program is more effective when compared to usual care, in preventing recurrence of low back pain in people recently recovered from an episode of non-specific low back pain. Participants were randomly allocated to one of two groups. One group received a walking and advice intervention delivered by a physiotherapist (3 face to face/video conferencing and 3 over the phone consultations, at no cost) and the other group received usual care which does not involve any intervention as part of the trial. https://australian.physio/research/prf/translation/walkback-trial

We are a proud partnership of the Sydney Local Health District and the University of Sydney.

©2023 Institute for Musculoskeletal Health

​

The Institute for Musculoskeletal Health acknowledges the Traditional Owners of Country throughout Australia where we work and live. We pay our respects to Elders past and present and celebrate the stories, culture and traditions of Aboriginal and Torres Strait Islander peoples.

bottom of page