Quality indicators for opioid stewardship interventions in hospital inpatient and emergency departments: a systematic review

A systematic review was conducted to identify existing quality indicators for opioid stewardship in hospital inpatient and emergency departments. Five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Scopus) and grey literature were searched up to April 2022 to identify articles containing quality indicators for opioid stewardship in the hospital setting. Quality indicators were classified into (1) structure, (2) process, and (3) outcome according to Donabedian model and further analysed as subgroups. Risk of bias assessment was performed by 2 independent reviewers. In total, 4621 articles were identified after duplicates were removed, of which 20 full-text articles were screened for eligibility and 8 articles included in the review. There were 81 quality indicators extracted, of which 49 were unique quality indicators. Analysis produced 25% (12/49) structure, 61% (30/49) process, and 14% (7/49) outcome quality indicators. These quality indicators may be used to developed future quality standards, although further study is needed to improve patient data collection for outcome quality indicators to allow for more holistic evaluation of opioid stewardship programs.