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Are Physicians Safely Prescribing Opioids for Chronic Noncancer Pain? A Systematic Review of Current Evidence.
Tournebize, Juliana; Gibaja, Valérie; Muszczak, Amandine; Kahn, Jean-Pierre.
Afiliación
  • Tournebize J; Centre for Evaluation and Information on Pharmacodependence-Addictovigilance, 'Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance' (CEIP-A), Nancy University Medical Center, Nancy, France.
  • Gibaja V; Centre for Evaluation and Information on Pharmacodependence-Addictovigilance, 'Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance' (CEIP-A), Nancy University Medical Center, Nancy, France.
  • Muszczak A; Centre for Evaluation and Information on Pharmacodependence-Addictovigilance, 'Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance' (CEIP-A), Nancy University Medical Center, Nancy, France.
  • Kahn JP; Centre for Evaluation and Information on Pharmacodependence-Addictovigilance, 'Centre d'Evaluation et d'Information sur la Pharmacodépendance-Addictovigilance' (CEIP-A), Nancy University Medical Center, Nancy, France.
Pain Pract ; 16(3): 370-83, 2016 Mar.
Article en En | MEDLINE | ID: mdl-25865462
BACKGROUND: With rising prescription of opioid medications for chronic noncancer pain (CNCP) in the past years, opioid abuse and overdose deaths have increased in parallel. To ensure adequate treatment outcomes and reduce the risks linked with the chronic use of opioids, practitioner's adherence to treatment guidelines is essential. This study summarizes published recommendations about the strategies to reduce the risks associated with the chronic use of opioids and evaluates the adherence of physicians to these recommendations. METHOD: A systematic literature search was undertaken in May 2014 using major databases. Studies were included if they examined the adherence of practitioners with at least one form of opioid risk reduction strategy. Benchmark guidelines cited in these studies were also reviewed. RESULTS: The search yielded 683 records, 14 of which were found to evaluate adherence of physicians to opioid risk reduction strategies. Nine benchmark guidelines were found. Almost all physicians consider opioid therapy only when other safer approaches have failed and do not prescribe opioids at doses greater than 200 mg/day of morphine equivalent. Unfortunately, less than 50% assess pain intensity using a pain scale; they often consider transdermal fentanyl safe for opioid-naïve patients and fail to discontinue opioids if they were ineffective in relieving patients' pain. CONCLUSIONS: Substantial practice and knowledge gaps were identified, including the use of pain scales and prescription of transdermal fentanyl in opioid-naïve patients, which have important implications for patient's safety. Guidelines more practical to physicians' settings and further education of physicians are warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Médicos / Analgésicos Opioides Tipo de estudio: Guideline / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Pain Pract Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Médicos / Analgésicos Opioides Tipo de estudio: Guideline / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Pain Pract Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos