Jesse Seilern Und Aspang, Mara L Schenker, Ada Port, Sharon Leslie, Nicholas A Giordano
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The study protocol was registered with PROSPERO (CRD42021234006).</p><p><strong>Data sources: </strong>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.</p><p><strong>Study selection: </strong>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.</p><p><strong>Data extraction: </strong>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. 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引用次数: 0
摘要
目的：本系统性综述评估了有关以患者为导向的阿片类药物和疼痛教育干预的文献，这些干预的目的是在骨科创伤人群中使用节省阿片类药物的方法优化疼痛管理。研究方案已在 PROSPERO 注册（CRD42021234006）：采用 PRISMA 指南对 CINAHL (EBSCO)、MEDLINE through PubMed、Embase.com、PsycInfo (EBSCO) 和 Web of Science Core Collection 文献数据库中 1980 年至 2021 年 2 月间发表的英文文献进行了回顾：只有在接受急性骨科治疗的成年患者中开展以患者为导向的阿片类药物和/或疼痛教育的研究才符合条件。研究结果必须包括介入治疗后阿片类药物的使用情况、术后镇痛和镇痛量或患者报告的疼痛结果：共审阅了 480 篇摘要，最终分析纳入了 8 篇出版物。两名审稿人使用标准化数据收集表独立提取了所选研究的数据。出现分歧时由第三位审稿人处理。研究质量采用 Cochrane 偏倚风险工具进行评估：描述性统计对研究结果进行了描述，并通过内容分析来确定各研究的主题：我们的研究结果表明，以患者为中心的教育干预措施（包括口头/书面/视听培训）与多模式方法相结合，可在急性骨科损伤后的紧急护理和急诊护理环境中针对阿片类药物稀释疼痛管理并降低短期疼痛评分。由于发表的文献较少，因此需要进一步进行严格设计的研究，以证实以患者为中心的教育在减少骨科创伤后长期使用阿片类药物及相关风险方面的益处：证据等级：三级治疗水平。
A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute care settings.
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.
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