Targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury - a randomised controlled trial Investigators: Prof Michele Sterling, Griffith Uni – physio, expert on whiplash injury Prof Stephan Schug, UWA – anaesthetist & pain specialist Prof Geoff Mitchell, UQ – GP & primary care Prof Sam McLean, Uni North Carolina, USA – ED Doctor Prof Luke Connelly, UQ – health economist Prof Steve Gibson, Uni Melb – psychologist Prof Rob Ware, GU - biostatistician Dr Jane Nikles, MHIQ Dr Gerben Keijzers, GCUH Dr John Leou, GCUH Dr Scott Farrell, MHIQ Supported by funding from: - NHMRC - Motor Accident Insurance Commission - MHIQ - Emergency Medicine Foundation

Whiplash Associated Disorders Back and neck pain are the most common cause of disability worldwide (Global Burden of Disease Study, Lancet, 2015) Whiplash is costly – greater costs than SCI and TBI (MAIC, 2012) 50% of people don’t recover – have chronic pain & disability (Sterling et al 2005, 2010, 2011) Current treatments aren’t very effective – advice/exercise/activity The early presence of pro-nociception is predictive of poor recovery – moderate evidence (Goldsmith et al 2012; Sterling et al 2012)

Question Why Pregabalin? Can pregabalin prevent the development of chronic pain after whiplash injury? Why Pregabalin? Pregabalin acts to block the development of central sensitisation Shows promise to prevent chronic post-surgical pain (Clarke et al, 2012; Mishriky et al, 2015; Eipe et al, 2015) Has effects on anxiety

Methodology Double blind, randomised, placebo-controlled trial comparing pregabalin and evidence-based advice (intervention) to placebo and evidence-based advice (control) Intervention will commence within 48 hours of injury and continue for 5 weeks – monitored by trial GP 75 mg initially, titrated up to 300 mg if tolerated

Inclusion Criteria Individuals with neck complaints and decreased range of motion and tenderness VAS ≥ 5/10 on arrival without fractures or neurological compromise Age 18-65 No history of depression or psychiatric dx

How can you help? Identify patients and call Research Team (numbers on posters around ED) Research staff will do bulk of paperwork, from doctors we need: Countersign informed consent Write trial script for Pregabalin

How can you help? If after hours 8.30 am to 8 pm (or research team not available)  complete Permission to Contact form (name, contact details, signatures from patient and MO/nurse) Put form back in folder ~30 seconds to 1 minute…

Located in folders at Minor Injuries, Resus and Triage

Contact Subaat Khan: P: 5552 9772 M: 0414 683 424 E: subaat.khan@griffithuni.edu.au Dr. Scott Farrell: P: 0400 550 548 E: s.farrell@griffith.edu.au Dr. Jane Nikles: P: 3382 3616 M: 0408 599 033 E: j.nikles@griffith.edu.au Dr. Gerben Keijzers: P: ‘Speed dial 27734’ E: gerben.keijzers@health.qld.gov.au Prof. Michele Sterling: P: 55529771  M: 0488 196 862 E: m.sterling@griffith.edu.au