Patient education interventions for prescription opioids: A systematic review

Kadakia, Nira N.; Rogers, Rachel L.; Reed, Jason; Dark, Erin R.; Plake, Kimberly S.

doi:10.1016/j.japh.2020.02.013

Cited by 9 publications

(3 citation statements)

References 31 publications

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“…Thus, prescription opioid interventions should focus on both exclusive pharmaceutical use as well as concurrent use with other non-pharmaceutical substances. At the patient level, prescribers and providers should be provided with tools to test patient knowledge and educational aids they can use to raise patient awareness about the dangers and risks of using these substances alone and in combination with other substances [38][39][40]. At the systemic level, preventing overdoses involving these substances should focus on managing the pharmaceutical supply and risks of polypharmacy by equipping prescribers, pharmacists and patients with resources such as easy to reference information about substance risks, and how and when they are suitable for use [41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

Ahmad,

Kakkar,

Rotondo

et al. 2024

Preprint

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Background Canada has seen a rise in substance-related accidental acute toxicity deaths (AATDs) in recent years. Research indicates that fentanyl opioids, non-fentanyl opioids, and stimulants are classes of concern and that multidrug AATDs have increased. However, there is limited information regarding the specific substances involved. This study aims to identify the substances and substance combinations as well as substance classes and substance class combinations most often involved in AATDs across Canada between 2016 and 2017. It also examines variations in substances by year and across sociodemographic, socioeconomic, and geographic factors. Methods Data were abstracted from the coroner and medical examiner files of all AATDs that occurred across Canada between 2016 and 2017. Top substances and classes detected in or contributing to AATDs were identified based on toxicology reports and cause of death statements. AATDs were stratified by year of death, age, sex, residence community type, neighbourhood income quintile, and province/region to understand variations in the substances contributing to AATDs. Combinations of substances and classes contributing to death were examined with UpSet plots and trends of select substances were visualized over time with ribbon charts. An algorithm was developed to report the source and origin of the substances based on prescription history and scene evidence. Results Fentanyl, cocaine, alcohol, and methamphetamine were the top substances contributing to the 7,902 AATDs identified between 2016 and 2017 in Canada. While stimulants and opioids were the most common substance classes contributing to AATDs, other classes, including benzodiazepines and acetaminophen also emerged as classes among the top contributors. Between 2016 and 2017, the proportion of AATDs attributable to diacetylmorphine (heroin) per quarter decreased while the proportion of AATDs attributable to carfentanil per quarter increased. AATDs involving more than one substance occurred across all sociodemographic, socioeconomic, and geographic groups. Substances contributing to AATDs more commonly originated from non-pharmaceutical sources than from pharmaceutical sources. Conclusions and impacts: Specific substances and substance combinations contributing to deaths vary over time and geographic areas. Opioids and stimulants are both detected in and contribute to a majority of AATDs, but the substance-related acute toxicity death crisis is complex and attributable to many substance classes. Understanding these differences will allow for targeted substance-related policies, prevention, and harm reduction efforts.

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Section: Discussionmentioning

confidence: 99%

Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

Ahmad,

Kakkar,

Rotondo

et al. 2024

Preprint

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“…[12,13] Previous reviews have illustrated the utility of patient education on curbing opioid-related risks or improving pain outcomes, yet, to date, no reviews have examined the utility of interventions on both opioid utilization and pain outcomes after orthopaedic trauma. In a systematic review of patient education interventions for prescription opioids, Kadakia et al [14] found that methods to educate patients about opioid medications have varying effects on patient knowledge of the medications and opioid-related medication adherence. Importantly, efforts to implement education on opioid safety offer a significant opportunity to incorporate patientcentered pain management education, which has been shown to improve pain outcomes and reduce opioid consumption for some orthopaedic surgical patients.…”

Section: Objectivesmentioning

confidence: 99%

“…[ 16 ] Among studies evaluating knowledge retention after patient education on opioid use, there is a paucity of research investigating the impact of patient education (and corresponding health literacy) on prescription opioid use in the acute care setting. [ 14 ] Moreover, scientific evidence on this topic dwindles when examining the patient population at highest risk for opioid misuse, namely the orthopaedic trauma patient. [ 17 ] Nevertheless, amid the abundance of clinical interventional studies examining the efficacy and impact of multimodal pain control, Horn and colleagues [ 18 ] determined in a systematic review that lower levels of postsurgical acute pain resulted in fewer opioid prescriptions.…”

Section: Objectivesmentioning

confidence: 99%

A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute care settings

Aspang

Schenker

Port³

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives:This systematic review evaluates the literature for patient-oriented opioid and pain educational interventions that aim to optimize pain management using opioid-sparing approaches in the orthopaedic trauma population. The study protocol was registered with PROSPERO (CRD42021234006).Data Sources:A review of English-language publications in CINAHL (EBSCO), MEDLINE through PubMed, Embase.com, PsycInfo (EBSCO), and Web of Science Core Collection literature databases published between 1980 and February 2021 was conducted using PRISMA guidelines.Study Selection:Only studies implementing patient-oriented opioid and/or pain education in adult patients receiving acute orthopaedic care were eligible. Outcomes were required to include postinterventional opioid utilization, postoperative analgesia and amount, or patient-reported pain outcomes.Data Extraction:A total of 480 abstracts were reviewed, and 8 publications were included in the final analysis. Two reviewers independently extracted data from selected studies using a standardized data collection form. Disagreements were addressed by a third reviewer. Quality of studies was assessed using the Cochrane Risk of Bias Tool.Data Synthesis:Descriptive statistics characterized study findings, and content analysis was used to discern themes across studies.Conclusion:Our findings indicate the merit for patient-centered educational interventions including verbal/written/audio–visual trainings paired with multimodal approaches to target opioid-sparing pain management and reduce short-term pain scores in urgent and acute care settings after acute orthopaedic injuries. The scarcity of published literature warrants further rigorously designed studies to substantiate the benefit of patient-centric education in reducing prolonged opioid utilization and associated risks after orthopaedic trauma.Level of Evidence:Therapeutic level III.

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Strategies to improve implementation of medications for opioid use disorder reported by veterans involved in the legal system: A qualitative study

Morse

Binswanger

Taylor

et al. 2021

Journal of Substance Abuse Treatment

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Patient education interventions for prescription opioids: A systematic review

Cited by 9 publications

References 31 publications

Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017

A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute care settings

Strategies to improve implementation of medications for opioid use disorder reported by veterans involved in the legal system: A qualitative study

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