Article type
Year
Abstract
Background: Despite an overall decline in opioid prescriptions in Canada, healthcare visits, hospitalizations, and deaths due to opioid-related harms continue to rise for children. Decision-makers (including families, clinicians, and policy-makers) require high quality syntheses to inform decisions regarding opioid use for children. Previous research has found that how systematic review (SR) results are presented may influence uptake by decision-makers. Evidence summaries are appealing to decision-makers as they provide key messages in a succinct manner.
Objectives: A) To conduct a SR examining the association between short-term therapeutic exposure to opioids and development of opioid use disorder, and B) To gain perspectives from policy decision-makers on the usability and presentation of results through the form of an evidence summary.
Methods: A) We conducted a SR following methods recommended by Cochrane. A medical librarian conducted a comprehensive search and two authors were involved in study selection, data extraction and quality assessment. Studies were eligible if they reported primary research in English or French, and participants had therapeutic exposure to opioids before age 18 years. Results were described narratively. B) Decision makers were recruited through purposive and snowball sampling methods. They participated in interviews to discuss an evidence summary about the SR. Interviews were transcribed and data was analyzed using latent content analysis.
Results: A) Of 4,072 unique citations, 16 studies (634,556 participants) were included. Five studies were comparative and explored the association between therapeutic exposure to opioids and opioid misuse; 11 studies were non-comparative and only reported on prevalence of misuse following therapeutic exposure. One comparative study showed an association between short-term therapeutic use and opioid misuse. The other four studying association lacked information on the duration of exposure; still, all suggested an association between therapeutic exposure and misuse.
B) Decision makers had mixed preferences for the presentation of evidence, depending on their role. A majority shared preferences for having statistics, methods and key characteristics of studies included in the evidence summary. They generally liked key messages highlighted on the first page, but noted the summary should not be too text-heavy.
Conclusions: Preliminary evidence suggests a link between lifetime therapeutic opioid use and opioid misuse; however, there is insufficient evidence available to determine whether short-term therapeutic exposure to opioids in childhood is definitively associated with these disorders. While this SR contributes evidence to guide clinical practice and future research, the qualitative findings help in understanding the type and format of information needed by policy decision-makers. PROSPERO Registration: 122681.
Patient or healthcare consumer involvement: Healthcare decision-makers were engaged to inform the development of effective knowledge translation tools.
Objectives: A) To conduct a SR examining the association between short-term therapeutic exposure to opioids and development of opioid use disorder, and B) To gain perspectives from policy decision-makers on the usability and presentation of results through the form of an evidence summary.
Methods: A) We conducted a SR following methods recommended by Cochrane. A medical librarian conducted a comprehensive search and two authors were involved in study selection, data extraction and quality assessment. Studies were eligible if they reported primary research in English or French, and participants had therapeutic exposure to opioids before age 18 years. Results were described narratively. B) Decision makers were recruited through purposive and snowball sampling methods. They participated in interviews to discuss an evidence summary about the SR. Interviews were transcribed and data was analyzed using latent content analysis.
Results: A) Of 4,072 unique citations, 16 studies (634,556 participants) were included. Five studies were comparative and explored the association between therapeutic exposure to opioids and opioid misuse; 11 studies were non-comparative and only reported on prevalence of misuse following therapeutic exposure. One comparative study showed an association between short-term therapeutic use and opioid misuse. The other four studying association lacked information on the duration of exposure; still, all suggested an association between therapeutic exposure and misuse.
B) Decision makers had mixed preferences for the presentation of evidence, depending on their role. A majority shared preferences for having statistics, methods and key characteristics of studies included in the evidence summary. They generally liked key messages highlighted on the first page, but noted the summary should not be too text-heavy.
Conclusions: Preliminary evidence suggests a link between lifetime therapeutic opioid use and opioid misuse; however, there is insufficient evidence available to determine whether short-term therapeutic exposure to opioids in childhood is definitively associated with these disorders. While this SR contributes evidence to guide clinical practice and future research, the qualitative findings help in understanding the type and format of information needed by policy decision-makers. PROSPERO Registration: 122681.
Patient or healthcare consumer involvement: Healthcare decision-makers were engaged to inform the development of effective knowledge translation tools.