The Effect of Opioid Stewardship Interventions on Key Outcomes: A Systematic Review
Autor: | Brandy Wyant, Sarah J Shoemaker-Hunt |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Leadership and Management implementation strategies Psychological intervention 03 medical and health sciences Patient safety 0302 clinical medicine Health care medicine Humans 030212 general & internal medicine Medical prescription Intensive care medicine Review Articles Urine drug screening business.industry 030503 health policy & services Public Health Environmental and Occupational Health opioids opioid stewardship Audit and feedback Analgesics Opioid Treatment Outcome Opioid ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Female Stewardship Patient Safety overdose 0305 other medical science business medicine.drug |
Zdroj: | Journal of Patient Safety |
ISSN: | 1549-8425 1549-8417 |
Popis: | Supplemental digital content is available in the text. Objectives We sought to identify potential patient safety practices to reduce high-risk opioid prescribing. Methods We conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. Included studies evaluated an OS strategy or a multicomponent OS initiative to address potential harms of opioids and used experimental or quasi-experimental designs. Results We identified 14 studies and 1 systematic review that met inclusion criteria. Most studies examined multicomponent OS interventions, which often consisted of guideline-recommended clinical interventions or care processes (e.g., use urine drug screening, check Prescription Drug Monitoring Program), as well as implementation strategies (e.g., dashboards, audit and feedback). Most studies examined the effect of OS interventions on reducing the potential risks of opioids with judicious prescribing and guideline-concordant care (e.g., reduce inappropriate high opioid dosages, avoid co-prescribing opioids and benzodiazepines, use urine drug screening, treatment agreements). Conclusions The strength of the evidence is low to moderate that OS efforts decrease numbers of opioid prescriptions, proportion of patients on long-term opioids, or days’ supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate. Future research is needed on the effectiveness of OS interventions, particularly studies with experimental designs and in diverse settings within the health care system. |
Databáze: | OpenAIRE |
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