Clinical Decision Support Systems for Opioid Prescribing for Chronic Non-Cancer Pain in Primary Care: A Scoping Review.

Analgesics, Opioid / therapeutic use Chronic Pain / drug therapy Decision Support Systems, Clinical Humans Practice Patterns, Physicians' Primary Health Care United States
Biomedical Technology Assessment Chronic Pain Clinical Decision Support Systems Clinical Decision-Making Electronic Health Records Information Technology Opioid-Related Disorders Outcomes Assessment Prescription Drug Monitoring Programs Translational Medical Research

Journal

Journal of the American Board of Family Medicine : JABFM
ISSN: 1558-7118
Titre abrégé: J Am Board Fam Med
Pays: United States
ID NLM: 101256526

Informations de publication

Date de publication:
Historique:
received: 30 05 2019
revised: 20 02 2020
accepted: 23 02 2020
entrez: 18 7 2020
pubmed: 18 7 2020
medline: 19 8 2021
Statut: ppublish

Résumé

Clinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions. We searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019. Two reviewers independently screened the citations. One reviewer extracted data and a second verified for accuracy. study of a CDSS for opioid prescribing for CNCP in a primary care clinical setting. We reported quantitative results in tables and qualitative results in narrative form. Our search yielded 5068 records, of which 14 studies met our inclusion criteria. All studies were conducted in the United States. Six studies examined local (eg, health center) CDSSs and 8 examined prescription drug monitoring program CDSSs. Three CDSSs incorporated evidence-based components. Study aims were heterogeneous and study designs included both quantitative and qualitative methodologies. No studies assessed patient health outcomes. Few studies appeared to be following guidance for evaluating complex interventions. Few studies have rigorously assessed the use of CDSSs for opioid prescribing for CNCP in primary care settings. Going forward, investigators should include evidence-based components into the design of CDSSs and follow guidance for the development and evaluation of complex interventions.

Sections du résumé

BACKGROUND AND OBJECTIVES
Clinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions.
METHODS
We searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019. Two reviewers independently screened the citations. One reviewer extracted data and a second verified for accuracy.
INCLUSION CRITERIA
study of a CDSS for opioid prescribing for CNCP in a primary care clinical setting. We reported quantitative results in tables and qualitative results in narrative form.
RESULTS
Our search yielded 5068 records, of which 14 studies met our inclusion criteria. All studies were conducted in the United States. Six studies examined local (eg, health center) CDSSs and 8 examined prescription drug monitoring program CDSSs. Three CDSSs incorporated evidence-based components. Study aims were heterogeneous and study designs included both quantitative and qualitative methodologies. No studies assessed patient health outcomes. Few studies appeared to be following guidance for evaluating complex interventions.
CONCLUSIONS
Few studies have rigorously assessed the use of CDSSs for opioid prescribing for CNCP in primary care settings. Going forward, investigators should include evidence-based components into the design of CDSSs and follow guidance for the development and evaluation of complex interventions.

Identifiants

DOI: 10.3122/jabfm.2020.04.190199 PMID: 32675264
pubmed: 32675264
pii: 33/4/529
doi: 10.3122/jabfm.2020.04.190199
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

529-540

Informations de copyright

© Copyright 2020 by the American Board of Family Medicine.

Auteurs

Sheryl Spithoff (S)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO). sheryl.spithoff@wchospital.ca.

Stephanie Mathieson (S)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

Frank Sullivan (F)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

Qi Guan (Q)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

Abhimanyu Sud (A)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

Susan Hum (S)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

Mary Ann O'Brien (MA)

From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO).

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Stupéfiants › Analgésiques morphiniques › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur chronique › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Systèmes d'information › Systèmes d'aide à la décision clinique › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Types de pratiques des médecins › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Clinical Decision Support Systems for Opioid...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Clinical Decision Support Systems for Opioid...