Interventions to Influence Opioid Prescribing Practices for Chronic Noncancer Pain: A Systematic Review and Meta-Analysis.

Analgesics, Opioid / therapeutic use Chronic Pain / drug therapy Humans North America Practice Patterns, Physicians' Prospective Studies

Journal

American journal of preventive medicine
ISSN: 1873-2607
Titre abrégé: Am J Prev Med
Pays: Netherlands
ID NLM: 8704773

Informations de publication

Date de publication:
01 2021
Historique:
received: 23 01 2020
revised: 09 06 2020
accepted: 16 07 2020
pubmed: 25 11 2020
medline: 24 6 2021
entrez: 24 11 2020
Statut: ppublish

Résumé

This study is a systematic review of interventions to improve adherence to guideline recommendations for prescribing opioids for chronic noncancer pain. Investigators searched CINAHL, Embase, MEDLINE, PsycINFO, the Cochrane Library, and Joanna Briggs Institute Evid Based Pract database from inception until June 3, 2019. Interventional studies to improve adherence to recommendations made by opioid guidelines for chronic noncancer pain in North America were eligible if outcomes included adherence to guideline recommendations or change in quantity of opioids prescribed. Data were extracted independently and in duplicate. Quantitative synthesis was performed using random effects meta-analysis. Confidence in evidence was determined using the Grades of Recommendation, Assessment, Development, and Evaluation. A total of 20 studies (8 controlled and 12 prospective cohort) involving 1,491 providers and 72 clinics met inclusion. Interventions included education, audit and feedback, interprofessional support, shared decision making, and multifaceted strategies. Multifaceted interventions improved the use of urine drug testing (n=2, or =2.31, 95% CI=1.53, 3.49, z=3.98, p<0.01; high-certainty evidence), treatment agreements (n=2, or =1.96, 95% CI=1.47, 2.61, z=4.56, p<0.01; moderate-certainty evidence), and mental health screening (n=2, 2.57-fold, 95% CI=1.56, 4.24, z=2.32, p=0.02; low-certainty evidence) when prescribing opioids for chronic noncancer pain. Very low-certainty evidence suggests that several interventions improved the use of treatment agreements, urine drug testing, and prescription drug monitoring programs. Mostly very low-certainty evidence supports a number of interventions for improving adherence to risk management strategies when prescribing opioids for chronic noncancer pain; however, the effect on patient important outcomes (e.g., overdose, addiction, death) is uncertain.

Identifiants

DOI: 10.1016/j.amepre.2020.07.012 PMID: 33229143
pubmed: 33229143
pii: S0749-3797(20)30341-X
doi: 10.1016/j.amepre.2020.07.012
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

e15-e26

Subventions

Organisme : CIHR
ID : 397972
Pays : Canada

Informations de copyright

Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Michael Asamoah-Boaheng (M)

Clinical Epidemiology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Oluwatosin A Badejo (OA)

Clinical Epidemiology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Louise V Bell (LV)

Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Norman Buckley (N)

Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.

Jason W Busse (JW)

Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada; The Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada.

Tavis S Campbell (TS)

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

Kim Corace (K)

The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada.

Lynn Cooper (L)

Canadian Injured Workers Alliance, Thunder Bay Ontario, Canada.

David Flusk (D)

Department of Anesthesia, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

David A Garcia (DA)

Clinical Epidemiology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Mohammad A Hossain (MA)

Clinical Epidemiology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Alfonso Iorio (A)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Kim L Lavoie (KL)

Department of Psychology, University of Quebec at Montreal, Montreal, Quebec, Canada; Montreal Behavioral Medicine Centre (MBMC), Centre intégrée universitaire de santé et services sociaux de Nord de l'Ile de Montreal (CIUSSS-NIM), Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada.

Patricia A Poulin (PA)

The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Psychology and Pain Clinic, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Becky Skidmore (B)

Independent Information Specialist, Ottawa, Ontario, Canada.

Joshua A Rash (JA)

Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada. Electronic address: jarash@mun.ca.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

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 › Interventions to Influence Opioid Prescribing...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur chronique › Interventions to Influence Opioid Prescribing...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Interventions to Influence Opioid Prescribing...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Interventions to Influence Opioid Prescribing...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Types de pratiques des médecins › Interventions to Influence Opioid Prescribing...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Interventions to Influence Opioid Prescribing...