Development and evaluation of a point-of-care tool for providers based on a meta-analysis and clinical practice guideline

Article type
Authors
Furlan A1, Flannery J1
1Toronto Rehabilitation Institute, UHN, Canada
Abstract
Background: Our group recently updated a meta-analysis of opioids for chronic pain. Based on our review, a national group developed a clinical practice guideline for safe and effective use of opioids for chronic non-cancer pain, which was released in 2010. However, the guideline is long and not practical to be used at the point of care by busy physicians, nurses or pharmacists. Our group decided to develop, evaluate, translate and adapt a tool which condenses the key elements from the guideline that could be used as a chart insert.

Objectives: To present the steps used to develop, evaluate, translate and adapt the Opioid ManagerTM, a two-page, colour document that was developed based on the opioid guideline.

Methods: We obtained funds from the Ministry of Health. In 2010, we developed a ‘draft Opioid Manager’ that was pilot tested over 9 months. We received feedback from 70 users. The final Opioid ManagerTM was released in February 2011. We integrated the OpioidManager to various ElectronicMedical Record (EMR) platforms. We used quantitative and qualitative methods to survey and interview users of the OpioidManager.

Results: The Opioid Manager is free of charge and can be downloaded from the guideline’s website. (See Fig. 1) As of April 2013, there are 4957 registered users who downloaded the tool. The Opioid Manager is integrated to six EMR platforms. It is translated to five languages (French, Spanish, Portuguese, Farsi and Italian). The Opioid Manager is available as an App for iOS and is Trade-Marked in Canada. See Figure 2 for the most common use by family physicians.

Conclusions: The development of a point of care tool is time and resource consuming. It is essential to develop tools to assist practitioners to apply the recommendations from clinical practice guidelines that are based on evidence from systematic reviews.