Evaluation of opioid requirements in the management of renal colic after guideline implementation in the emergency department

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department

“…Of these, 180 were kept for full-text review, and 63 unique studies were included in the review ( Figure 1 ). 12 , 27 , 28 , 29 , 30 , 31 , 32 , 35 , 36 , 37 , 39 , 40 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , …”

“… 69 , 94 , 102 All studies were published within the last 10 years (2013 to 2021). Studies used mainly preintervention-postintervention (n = 39) 12 , 28 , 30 , 31 , 32 , 35 , 39 , 40 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 92 , 93 , 94 , 99 , 100 , 101 , 102 and ITS (n = 21) 27 , 29 , 36 , 37 , 54 , 55 , 56 , 57 , 71 , 72 , 73 , 74 , 87 , 88 , 89 , 90 , 91 , ...…”

“…Ten of 21 ITS studies 27 , 36 , 54 , 55 , 56 , 57 , 88 , 89 , 90 , 91 demonstrated an overall moderate risk of bias (ROBINS-I); all other ITS and preintervention-postintervention studies 12 , 28 , 29 , 30 , 31 , 32 , 35 , 37 , 39 , 40 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 87 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , ...…”

“…Of 51 studies assessing prescribing rates, 46 (90%) reported a reduction after intervention implementation (34 were statistically significant). 12 , 27 , 28 , 29 , 31 , 32 , 54 , 55 , 56 , 57 , 58 , 59 , 62 , 63 , 64 , 65 , 66 , 67 , 69 , 76 , 77 , 78 , 79 , 80 , 82 , 84 , 85 , 86 , 88 , 90 , 94 , 100 , 101 Of 39 studies assessing prescribed opioid quantity, 32 (82%) reported an intervention-related reduction (17 were statistically significant). 35 , 36 , 39 , 40 , 55 , 65 , 68 , 70 , 82 , 83 , 84 , 85 , 86 , 95 , 98 , 100 , 101 …”

Canadian Urological Association guideline: Management of ureteral calculi – Abridged version

“…However, opioid-sparing approaches were associated with higher rates of repeat visits to the ED. 46 Discharge prescriptions can vary significantly based on the patient population and comorbidities. Accounting for important patient characteristics (e.g., post-traumatic stress disorder, anxiety/depression, chronic pain syndromes) when prescribing analgesia for acute renal colic is also important.…”