Healthcare provider knowledge, attitudes, beliefs, and practices surrounding the prescription of opioids for chronic non-cancer pain in North America: protocol for a mixed-method systematic review

被引：10

作者：

Rash, Joshua A. ^{[1
]}

Buckley, Norman ^{[2
]}

Busse, Jason W. ^{[2
,3
,4
,5
]}

Campbell, Tavis S. ^{[6
]}

Corace, Kim ^{[7
,8
,9
]}

Cooper, Lynn ^{[10
]}

Flusk, David ^{[11
]}

Iorio, Alfonso ^{[3
]}

Lavoie, Kim L. ^{[12
,13
]}

Poulin, Patricia A. ^{[14
,15
,16
,17
]}

Skidmore, B.

机构：

[1] Mem Univ Newfoundland, Dept Psychol, 230 Elizabeth Ave, St John, NF A1B 3X9, Canada

[2] McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada

[3] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[4] McMaster Univ, Michael G DeGroote Inst Pain Res & Care, Hamilton, ON, Canada

[5] McMaster Univ, Michael G DeGroote Ctr Med Cannabis Res, Hamilton, ON, Canada

[6] Univ Calgary, Dept Psychol, Calgary, AB, Canada

[7] Royal Ottawa Mental Hlth Ctr, Ottawa, ON, Canada

[8] Univ Ottawa, Dept Psychiat, Ottawa, ON, Canada

[9] Univ Ottawa, Inst Mental Hlth Res, Ottawa, ON, Canada

[10] Canadian Injured Workers Alliance, Thunder Bay, ON, Canada

[11] Mem Univ Newfoundland, Dept Anesthesia, St John, NF, Canada

[12] Univ Quebec Montreal, Dept Psychol, Montreal, PQ, Canada

[13] Hop Sacre Coeur Montreal, MBMC, CIUSSS NIM, Montreal, PQ, Canada

[14] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[15] Ottawa Hosp Pain Clin, Ottawa, ON, Canada

[16] Univ Ottawa, Sch Psychol, Ottawa, ON, Canada

[17] Univ Ottawa, Dept Anesthesiol & Pain Med, Ottawa, ON, Canada

来源：

SYSTEMATIC REVIEWS | 2018年 / 7卷

关键词：

Clinical inertia; Clinical practice guideline adherence; Opioids; Chronic pain; Systematic review; UNITED-STATES; PRESCRIBING OPIOIDS; FAMILY PHYSICIANS; CDC GUIDELINE; MORTALITY; QUALITY; PREVALENCE; MANAGEMENT; ADHERENCE; ABUSE;

D O I：

10.1186/s13643-018-0858-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Evidence from diverse areas of medicine (e.g., cardiovascular disease, diabetes) indicates that healthcare providers (HCPs) often do not adhere to clinical practice guidelines (CPGs) despite a clear indication to implement recommendations-a phenomenon commonly termed clinical inertia. There are a variety of reasons for clinical inertia, but HCP-related factors (e.g., knowledge, motivation, agreement with guidelines) are the most salient and amenable to intervention aimed to improve adherence. CPGs have been developed to support the safe and effective prescription of opioid medication for the management of chronic non-cancer pain. The extent of physician uptake and adherence to such guidelines is not yet well understood. The purpose of this review is to synthesize the published evidence about knowledge, attitudes, beliefs, and practices that HCPs hold regarding the prescription of opioids for chronic non-cancer pain. Methods: An experienced information specialist will perform searches of CINAHL, Embase, MEDLINE, and PsycINFO bibliographic databases. The Cochrane library, PROSPERO, and the Joanna Briggs Institute will be searched for systematic reviews. Searches will be performed from inception to the present. Quantitative and qualitative study designs that report on HCP knowledge, attitudes, beliefs, or practices in North America will be eligible for inclusion. Studies reporting on interventions to improve HCP adherence to opioid prescribing CPGs will also be eligible for inclusion. Two trained graduate-level research assistants will independently screen articles for inclusion, perform data extraction, and perform risk of bias and quality assessment using recommended tools. Confidence in qualitative evidence will be evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews (GRADE-CERQual) approach. Confidence in quantitative evidence will be assessed using the GRADE approach. Discussion: The ultimate goal of this work is to support interventions aiming to optimize opioid prescribing practices in order to prevent opioid-related morbidity and mortality without restricting a HCP's ability to select the most appropriate treatment for an individual patient.

引用

页数：9

共 78 条

[1] Specific instructions for estimating unclearly reported blinding status in randomized trials were reliable and valid [J].

Akl, Elie A. ;

Sun, Xin ;

Busse, Jason W. ;

Johnston, Bradley C. ;

Briel, Matthias ;

Mulla, Sohail ;

You, John J. ;

Bassler, Dirk ;

Lamontagne, Francois ;

Vera, Claudio ;

Alshurafa, Mohamad ;

Katsios, Christina M. ;

Heels-Ansdell, Diane ;

Zhou, Qi ;

Mills, Ed ;

Guyatt, Gordon H. .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 2012, 65 (03) :262-267

[2] Self-reported practices in opioid management of chronic noncancer pain: A survey of Canadian family physicians [J].

Allen, Michael J. M. ;

Asbridge, Mark M. ;

MacDougall, Peter C. ;

Furlan, Andrea D. ;

Tugalev, Oleg .

PAIN RESEARCH & MANAGEMENT, 2013, 18 (04) :177-184

[3] Opioid-induced hyperalgesia - A qualitative systematic review [J].

Angst, MS ;

Clark, JD .

ANESTHESIOLOGY, 2006, 104 (03) :570-587

[4]

[Anonymous], 1979, Pain, V6, P249

[5]

[Anonymous], 2001, SYSTEMATIC REV HLTH, DOI DOI 10.1002/9780470693926

[6]

[Anonymous], 2016, EUR DRUG REP 2016

[7]

[Anonymous], PAN CAN TRENDS PRESC

[8]

[Anonymous], HHS PUBL

[9]

[Anonymous], NAT M SAF STAT ALL

[10]

[Anonymous], J CLIN EPIDEMIOL

← 1 2 3 4 5 6 7 8 →