Relative frequency and risk factors for long-term opioid therapy following surgery and trauma among adults: a systematic review protocol.

Autor: Pagé MG; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Tour Saint-Antoine S01-112, 850 rue St-Denis, Montreal, QC, H2X 0A9, Canada. gabrielle.page@umontreal.ca.; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Pavillon Roger-Gaudry, local S-712, C.P. 6128, Succ. Centre-ville, Montréal, QC, H3C 3J7, Canada. gabrielle.page@umontreal.ca., Kudrina I; Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Ch de la Côte des Neiges, Montreal, QC, H3S 1Z1, Canada., Zomahoun HTV; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 ave de la Médecine, local 2431, Québec, QC, G1V 0A6, Canada.; Health and Social Services Systems, Knowledge Translation and Implementation Component of the Quebec SPOR-SUPPORT Unit, Pavillon Landry-Poulin, 2525, Chemin de la Canardiere, Quebec, QC, G1J 0A4, Canada., Ziegler D; Department of Information Science, Hotel Dieu, 3840 Saint-Urbain Pavillon Olier 4e étage porte 2-428, Montreal, QC, H2W 1T8, Canada., Beaulieu P; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Pavillon Roger-Gaudry, local S-712, C.P. 6128, Succ. Centre-ville, Montréal, QC, H3C 3J7, Canada.; Anesthesiology Department, Centre hospitalier de l'Université de Montréal, 1051 rue Sanguinet, Montreal, QC, H2X 0C1, Canada., Charbonneau C; Association Québécoise de la douleur chronique (AQDC), bureau 403, 2030 boul. Pie-IX, Montreal, QC, H1V 2C8, Canada., Cogan J; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Pavillon Roger-Gaudry, local S-712, C.P. 6128, Succ. Centre-ville, Montréal, QC, H3C 3J7, Canada.; Department of Anesthesiology, Montreal Heart Institute, 5000 Bélanger, Montreal, QC, H1T 1C8, Canada., Daoust R; Emergency medicine, Hôpital du Sacré-Coeur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC, H4J 1C5, Canada., Martel MO; Faculty of Dentistry, McGill University, 2001 Avenue McGill College, |500, Montreal, QC, H3A 1G1, Canada., Néron A; Clinique de la douleur, Département de pharmacie, Centre hospitalier de l'Université de Montréal, 5e, Pav C - C0550, 1051 rue Sanguinet, Montreal, QC, H2X 0C1, Canada., Richebé P; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Pavillon Roger-Gaudry, local S-712, C.P. 6128, Succ. Centre-ville, Montréal, QC, H3C 3J7, Canada.; Department of Anesthesiology, Hôpital Maisonneuve-Rosemont, 5415 Assumption Blvd, Montreal, QC, H1T 2M4, Canada., Clarke H; Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, 200 Elizabeth St 3EN-464, Toronto, ON, M5G 2C4, Canada.; Transitional Pain Service, Toronto General Hospital, University Health Network, 200 Elizabeth St 3EN-464, Toronto, ON, M5G 2C4, Canada.
Jazyk: angličtina
Zdroj: Systematic reviews [Syst Rev] 2018 Jul 18; Vol. 7 (1), pp. 97. Date of Electronic Publication: 2018 Jul 18.
DOI: 10.1186/s13643-018-0760-3
Abstrakt: Background: When patients have been on opioid therapy for more than 90 days, more than half of them continue using opioids years later. Knowing that long-term opioid consumption could lead to harmful side effects including misuse, abuse, and addiction, it is important to understand the risks of transitioning to prolonged opioid therapy to reduce its occurrence. Perioperative and trauma contexts are ideal models commonly used to study such transition. Long-term use of opioids might be associated with transformation of acute pain to chronic, which might be an example of a risk factor. The objectives of this knowledge synthesis are to examine the relative frequency and the risk factors for transitioning to long-term opioid therapy among patients who have undergone a surgical procedure or experienced a trauma.
Methods: The proposed study methodology is based on Preferred ReportIng Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statements on the conduct of systematic review and meta-analysis, the MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies, and the Cochrane Handbook for Systematic Review of Interventions. A systematic literature search will include multiple databases: Cochrane Central, EMBASE, MEDLINE, PsycINFO, CINHAL, PubMed, and the grey literature. We will identify studies related to opioid use beyond acute/subacute pain control after surgery or trauma. Two of the reviewers will screen all retrieved articles for eligibility and data extraction then critically appraise all identified studies. We will compile a narrative synthesis of all results and conduct a meta-analysis when feasible. As available data permits, we will perform a subgroup analysis of vulnerable populations.
Discussion: This systematic review will contribute to the prevention and harm reduction strategies associated with prescription opioids by identifying risk factors leading to the unwarranted long-term opioid therapy. The identification of common risk factors for long-term opioid therapy will help to orient further research on pain management as well as offer key therapeutic targets for the development of strategies to prevent prolonged opioid use.
Systematic Review Registration: This protocol was registered in PROSPERO on March 2, 2018; registration number CRD42012018089907 .
Databáze: MEDLINE
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