Evidence map›Paper›PMID 33514325›Full record

SynthesisBMC emergency medicine2021

Association between supportive interventions and healthcare utilization and outcomes in patients on long-term prescribed opioid therapy presenting to acute healthcare settings: a systematic review and meta-analysis.

Jean Deschamps, James Gilbertson, Sebastian Straube, Kathryn Dong, Frank P MacMaster, Christina Korownyk, Lori Montgomery, Ryan Mahaffey, James Downar, Hance Clarke and 9 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Jean DeschampsDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada. jean3@ualberta.ca.ORCID 0000-0002-4872-3334
James GilbertsonSchool of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Sebastian StraubeDivision of Preventive Medicine, Department of Medicine, University of Alberta, 5-30 University Terrace, 8303 - 112 St NW, Edmonton, Alberta, T6G 2T4, Canada.
Kathryn DongDepartment of Emergency Medicine, University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, 8440 112 St NW, Edmonton, Alberta, T6G 2R7, Canada.
Frank P MacMasterDepartments of Psychiatry and Pediatrics, University of Calgary, Strategic Clinical Network for Addictions and Mental Health 2888 Shaganappi Trail NW Calgary, Calgary, Alberta, T3B 6A8, Canada.
Christina KorownykDepartment of Family Medicine, University of Alberta, Suite 205 College Plaza, 8215 112 St NW, Edmonton, Alberta, T6G 2C8, Canada.
Lori MontgomeryDepartment of Family Medicine, Calgary Chronic Pain Center 1820 Richmond Road SW Calgary, Calgary, Alberta, T2T 5C7, Canada.
Ryan MahaffeyDepartment of Anesthesia, University of Ottawa, Ottawa, Ontario, Canada.
James DownarDepartment of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Hance ClarkeDepartment of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Ottawa, Ontario, Canada.
John MuscedereDepartment of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada.
Katherine RittenbachAddiction & Mental Health Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada.
Robin FeatherstoneAlberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Alberta SPOR SUPPORT Unit KT Platform, 4-486D Edmonton Clinical Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
Meghan SebastianskiKnowledge Translation Platform, Alberta SPOR SUPPORT Unit Department of Pediatrics, University of Alberta, 362-B Heritage Medical Research Centre (HMRC), Edmonton, Canada.
Ben VandermeerAlberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Alberta SPOR SUPPORT Unit KT Platform, 4-486D Edmonton Clinical Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
Deborah LynamPrimary Health Care Information Network, Edmonton, Alberta, Canada.
Ryan MagnussenCritical Care Strategic Clinical Network, Foothills Medical Centre, ICU Administration - Ground Floor, McCaig Tower, 3134 Hospital Drive, Calgary, Alberta, T2N 2T9, Canada.
Sean M BagshawDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.
Oleksa G RewaDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440 112 St. NW, Critical Care Medicine 2-124E Clinical Sciences Building, Edmonton, Alberta, T6G 2B7, Canada.

Funding

SPOR - University of Alberta N/A
6 · The paper itself

Abstract

backgroundLong-term prescription of opioids by healthcare professionals has been linked to poor individual patient outcomes and high resource utilization. Supportive strategies in this population regarding acute healthcare settings may have substantial impact.

methodsWe performed a systematic review and meta-analysis of primary studies. The studies were included according to the following criteria: 1) age 18 and older; 2) long-term prescribed opioid therapy; 3) acute healthcare setting presentation from a complication of opioid therapy; 4) evaluating a supportive strategy; 5) comparing the effectiveness of different interventions; 6) addressing patient or healthcare related outcomes. We performed a qualitative analysis of supportive strategies identified. We pooled patient and system related outcome data for each supportive strategy.

resultsA total of 5664 studies were screened and 19 studies were included. A total of 9 broad categories of supportive strategies were identified. Meta-analysis was performed for the "supports for patients in pain" supportive strategy on two system-related outcomes using a ratio of means. The number of emergency department (ED) visits were significantly reduced for cohort studies (n = 6, 0.36, 95% CI [0.20-0.62], I

conclusionFor patients presenting to acute healthcare settings with complications related to long-term opioid therapy, the intervention with the most robust data is "supports for patients in pain".

Indexed as

Analgesics, OpioidPatient Acceptance of Health CareAdolescentEmergency Service, HospitalHumansPainPatient DischargeAnalgesics, OpioidAddiction medicineDrug abuseHospital medicineOpioidSubstance-related disorders

Identifiers

PMID33514325
PMCPMC7845034

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.