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Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis

INTRODUCTION: Opioids are routinely used to treat a variety of chronic conditions associated with pain. However, they are a class of medications with a significant potential for adverse health effects, with and without misuse. Opioid misuse, as defined as inappropriate use of appropriately prescribe...

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Autores principales: Deschamps, Jean, Gilbertson, James, Straube, Sebastian, Dong, Kathryn, MacMaster, Frank P., Korownyk, Christina, Montgomery, Lori, Mahaffey, Ryan, Downar, James, Clarke, Hance, Muscedere, John, Rittenbach, Katherine, Featherstone, Robin, Sebastianski, Meghan, Vandermeer, Ben, Lynam, Deborah, Magnussen, Ryan, Bagshaw, Sean M., Rewa, Oleksa G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449896/
https://www.ncbi.nlm.nih.gov/pubmed/30953550
http://dx.doi.org/10.1186/s13643-019-0997-5
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author Deschamps, Jean
Gilbertson, James
Straube, Sebastian
Dong, Kathryn
MacMaster, Frank P.
Korownyk, Christina
Montgomery, Lori
Mahaffey, Ryan
Downar, James
Clarke, Hance
Muscedere, John
Rittenbach, Katherine
Featherstone, Robin
Sebastianski, Meghan
Vandermeer, Ben
Lynam, Deborah
Magnussen, Ryan
Bagshaw, Sean M.
Rewa, Oleksa G.
author_facet Deschamps, Jean
Gilbertson, James
Straube, Sebastian
Dong, Kathryn
MacMaster, Frank P.
Korownyk, Christina
Montgomery, Lori
Mahaffey, Ryan
Downar, James
Clarke, Hance
Muscedere, John
Rittenbach, Katherine
Featherstone, Robin
Sebastianski, Meghan
Vandermeer, Ben
Lynam, Deborah
Magnussen, Ryan
Bagshaw, Sean M.
Rewa, Oleksa G.
author_sort Deschamps, Jean
collection PubMed
description INTRODUCTION: Opioids are routinely used to treat a variety of chronic conditions associated with pain. However, they are a class of medications with a significant potential for adverse health effects, with and without misuse. Opioid misuse, as defined as inappropriate use of appropriately prescribed opioids, is becoming more well-recognized publicly but does not have clear treatment options. Opioid misuse has been linked to variety of poor outcomes and its consequences have a significant impact on healthcare resource utilization. The evidence on harm reduction strategies to mitigate adverse events prompting presentation to acute care settings for patients presenting with long-term opioid use is sparse. METHODS AND ANALYSIS: We will perform a systematic review and meta-analysis to catalog effective harm reduction strategies and identify the most effective ones to reduce avoidable healthcare utilization in patients on long-term opioid therapy who present to acute health care settings with complications attributed to opioid misuse. A search strategy will be developed and executed by an information specialist; electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library) and additional sources will be searched. Search themes will include opioids, chronic drug use, and acute healthcare settings. Citation screening, selection, quality assessment, and data abstraction will be performed in duplicate. A comprehensive inventory of harm reduction strategies will be developed. Data will be collected on patient-related outcomes associated with each identified harm reduction strategy. When sufficiently homogeneous data on interventions, population, and outcomes is available, it will be pooled for aggregate analysis. Evaluation of the methodological quality of individual studies and of the quality of the body of evidence will be performed. Our primary objective will be to identify harm reduction strategies that have been shown to result in clinically relevant and statistically significant improvements in patient outcomes and/or decreased healthcare utilization. DISCUSSION: This study will better characterize harm reduction strategies for patients on long-term prescribed opioids presenting to acute healthcare settings. It will also add new knowledge and generate greater understanding of key knowledge gaps of the long-term prescribed opioid use and its impact on healthcare utilization. SYSTEMATIC REVIEW REGISTRATION: CRD42018088962. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-019-0997-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-64498962019-04-15 Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis Deschamps, Jean Gilbertson, James Straube, Sebastian Dong, Kathryn MacMaster, Frank P. Korownyk, Christina Montgomery, Lori Mahaffey, Ryan Downar, James Clarke, Hance Muscedere, John Rittenbach, Katherine Featherstone, Robin Sebastianski, Meghan Vandermeer, Ben Lynam, Deborah Magnussen, Ryan Bagshaw, Sean M. Rewa, Oleksa G. Syst Rev Protocol INTRODUCTION: Opioids are routinely used to treat a variety of chronic conditions associated with pain. However, they are a class of medications with a significant potential for adverse health effects, with and without misuse. Opioid misuse, as defined as inappropriate use of appropriately prescribed opioids, is becoming more well-recognized publicly but does not have clear treatment options. Opioid misuse has been linked to variety of poor outcomes and its consequences have a significant impact on healthcare resource utilization. The evidence on harm reduction strategies to mitigate adverse events prompting presentation to acute care settings for patients presenting with long-term opioid use is sparse. METHODS AND ANALYSIS: We will perform a systematic review and meta-analysis to catalog effective harm reduction strategies and identify the most effective ones to reduce avoidable healthcare utilization in patients on long-term opioid therapy who present to acute health care settings with complications attributed to opioid misuse. A search strategy will be developed and executed by an information specialist; electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library) and additional sources will be searched. Search themes will include opioids, chronic drug use, and acute healthcare settings. Citation screening, selection, quality assessment, and data abstraction will be performed in duplicate. A comprehensive inventory of harm reduction strategies will be developed. Data will be collected on patient-related outcomes associated with each identified harm reduction strategy. When sufficiently homogeneous data on interventions, population, and outcomes is available, it will be pooled for aggregate analysis. Evaluation of the methodological quality of individual studies and of the quality of the body of evidence will be performed. Our primary objective will be to identify harm reduction strategies that have been shown to result in clinically relevant and statistically significant improvements in patient outcomes and/or decreased healthcare utilization. DISCUSSION: This study will better characterize harm reduction strategies for patients on long-term prescribed opioids presenting to acute healthcare settings. It will also add new knowledge and generate greater understanding of key knowledge gaps of the long-term prescribed opioid use and its impact on healthcare utilization. SYSTEMATIC REVIEW REGISTRATION: CRD42018088962. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-019-0997-5) contains supplementary material, which is available to authorized users. BioMed Central 2019-04-05 /pmc/articles/PMC6449896/ /pubmed/30953550 http://dx.doi.org/10.1186/s13643-019-0997-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Protocol
Deschamps, Jean
Gilbertson, James
Straube, Sebastian
Dong, Kathryn
MacMaster, Frank P.
Korownyk, Christina
Montgomery, Lori
Mahaffey, Ryan
Downar, James
Clarke, Hance
Muscedere, John
Rittenbach, Katherine
Featherstone, Robin
Sebastianski, Meghan
Vandermeer, Ben
Lynam, Deborah
Magnussen, Ryan
Bagshaw, Sean M.
Rewa, Oleksa G.
Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title_full Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title_fullStr Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title_full_unstemmed Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title_short Association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
title_sort association between harm reduction strategies and healthcare utilization in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a protocol for a systematic review and meta-analysis
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449896/
https://www.ncbi.nlm.nih.gov/pubmed/30953550
http://dx.doi.org/10.1186/s13643-019-0997-5
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