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Digestive Diseases and Sciences
Erschienen in: Digestive Diseases and Sciences 10/2017

05.08.2017 | Review

Strategies to Identify and Reduce Opioid Misuse Among Patients with Gastrointestinal Disorders: A Systematic Scoping Review

verfasst von: Salva N. Balbale, Itishree Trivedi, Linda C. O’Dwyer, Megan C. McHugh, Charlesnika T. Evans, Neil Jordan, Laurie A. Keefer

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2017

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Abstract

Background

Scoping reviews are preliminary assessments intended to characterize the extent and nature of emerging research evidence, identify literature gaps, and offer directions for future research. We conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders.

Methods

We performed structured keyword searches to identify manuscripts published through June 2016 in the PubMed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases to extract original research articles that described healthcare practices, tools, or interventions to identify and reduce opioid misuse among GI patients. The Chronic Care Model (CCM) was used to classify the strategies presented.

Results

Twelve articles met the inclusion criteria. A majority of studies used quasi-experimental or retrospective cohort study designs. Most studies addressed the CCM’s clinical information systems element. Seven studies involved identification of opioid misuse through prescription drug monitoring and opioid misuse screening tools. Four studies discussed reductions in opioid use by harnessing drug monitoring data and individual care plans, and implementing self-management and opioid detoxification interventions. One study described drug monitoring and an audit-and-feedback intervention to both identify and reduce opioid misuse. Greatest reductions in opioid misuse were observed when drug monitoring, self-management, or audit-and-feedback interventions were used.

Conclusion

Prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. Rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
Literatur
1.
2.
3.
Owens PL, Barrett ML, Weiss AJ, et al. Hospital inpatient utilization related to opioid overuse among adults, 1993–2012. Healthcare Cost and Utilization Project Statistical Brief. 2014;177.
4.
Xie L, Joshi AV, Schaaf D, et al. Differences in healthcare utilization and associated costs between patients prescribed vs. nonprescribed opioids during an inpatient or emergency department visit. Pain Pract. 2014;14:446–456.PubMed
5.
Levy B, Paulozzi L, Mack KA, et al. Trends in opioid analgesic-prescribing rates by specialty, US, 2007–2012. Am J Prev Med. 2015;49:409–413.CrossRefPubMed
6.
Logan J, Liu Y, Paulozzi L, et al. Opioid prescribing in emergency departments: the prevalence of potentially inappropriate prescribing and misuse. Med Care. 2013;51:646–653.CrossRefPubMed
7.
Paulozzi LJ, Mack KA, Hockenberry JM. Vital signs: variation among states in prescribing of opioid pain relievers and benzodiazepines—United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63:563–568.PubMed
8.
Becker WC, Tobin DG, Fiellin DA. Nonmedical use of opioid analgesics obtained directly from physicians: prevalence and correlates. Arch Intern Med. 2011;171:1034–1036.CrossRefPubMed
9.
Murphy SL, Xu J, Kochanek KD. Deaths: preliminary data for 2010. National Center for Health Statistics. 2012;60:1–52.
10.
Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999–2006. National Center for Health Statistics Data Brief. 2009;22:1–8.
11.
12.
13.
Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. J Am Med Assoc. 2016;315:1624–1645.CrossRef
14.
Cahana A, Dansie EJ, Theodore BR, et al. Redesigning delivery of opioids to optimize pain management, improve outcomes, and contain costs. Pain Med. 2013;14:36–42.CrossRefPubMed
15.
Califf RM, Woodcock J, Ostroff S. A proactive response to prescription opioid abuse. New Engl J Med. 2016;374:1480–1485.CrossRefPubMed
16.
Becker WC, Fraenkel L, Kerns RD, et al. A research agenda for enhancing appropriate opioid prescribing in primary care. J Gen Intern Med. 2013;28:1364–1367.CrossRefPubMedPubMedCentral
17.
Buckley JP, Kappelman MD, Allen JK, et al. The burden of comedication among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:2725–2736.CrossRefPubMed
18.
Choung RS, Locke GR, Schleck CD, et al. Associations between medication use and functional gastrointestinal disorders: a population-based study. Neurogastroenterol Motil. 2013;25:413–419.CrossRefPubMedPubMedCentral
19.
Hsia RY, Nath JB, Baker LC. California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005–11. Health Aff (Millwood).. 2015;34:621–626.CrossRefPubMedPubMedCentral
20.
Myer PA, Mannalithara A, Singh G, et al. Clinical and economic burden of emergency department visits due to gastrointestinal diseases in the United States. Am J Gastroenterol. 2013;108:1496–1507.CrossRefPubMed
21.
Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143:1179–1187.CrossRefPubMedPubMedCentral
22.
Cross RK, Wilson KT, Binion DG. Narcotic use in patients with Crohn’s disease. Am J Gastroenterol. 2005;100:2225–2229.CrossRefPubMed
23.
Srinath A, Young E, Szigethy E. Pain management in patients with inflammatory bowel disease: translational approaches from bench to bedside. Inflamm Bowel Dis. 2014;20:2433–2449.CrossRefPubMed
24.
Mazer-Amirshahi M, Mullins PM, Rasooly I, et al. Rising opioid prescribing in adult US emergency department visits: 2001–2010. Acad Emerg Med. 2014;21:236–243.CrossRefPubMed
25.
Dorn SD, Meek PD, Shah ND. Increasing frequency of opioid prescriptions for chronic abdominal pain in US outpatient clinics. Clin Gastroenterol Hepatol. 2011;9:1078–1085.CrossRefPubMed
26.
Dorn SD, Meek PD, Shah ND. United States patients with chronic abdominal pain are increasingly prescribed opioid analgesics. Gastroenterology. 2011;140:S206.
27.
Hanson KA, Loftus EV, Harmsen WS, et al. Clinical features and outcome of patients with inflammatory bowel disease who use narcotics: a case–control study. Inflamm Bowel Dis. 2009;15:772–777.CrossRefPubMed
28.
Kanuri ND, Abraham P, Cassell B, et al. Clinical factors associated with opioid prescription use among irritable bowel syndrome (IBS) patients. Gastroenterology. 2015;148:S658.
29.
Nusrat S, Yadav D, Bielefeldt K. Pain and opioid use in chronic pancreatitis. Pancreas. 2012;41:264–270.CrossRefPubMed
30.
Targownik LE, Nugent Z, Singh H, et al. The prevalence and predictors of opioid use in inflammatory bowel disease: a population-based analysis. Am J Gastroenterol. 2014;109:1613–1620.CrossRefPubMed
31.
Lev R, Lee O, Petro S, et al. Who is prescribing controlled medications to patients who die of prescription drug abuse? Am J Emerg Med. 2016;34:30–35.CrossRefPubMed
32.
Edwards JT, Radford-Smith GL, Florin TH. Chronic narcotic use in inflammatory bowel disease patients: prevalence and clinical characteristics. J Gastroenterol Hepatol. 2001;16:1235–1238.CrossRefPubMed
33.
Freeman HJ. Is narcotic addiction more prevalent in IBD patients? Inflamm Bowel Dis. 2008;14:S56.CrossRefPubMed
34.
Barth K, Balliet W, Adams D, et al. Predictors of opioid misuse among patients with chronic non-alcoholic pancreatitis pain. Ann Behav Med. 2012;43:S200.
35.
Fenton BW, Durner C, Fanning J. Frequency and distribution of multiple diagnoses in chronic pelvic pain related to previous abuse or drug-seeking behavior. Gynecol Obstet Investig. 2008;65:247–251.CrossRef
36.
Patel B, Fahed J, Han S, et al. Narcotic use and quality of life in chronic pancreatitis patients. Gastroenterology. 2016;150:S909–S910.CrossRef
37.
Sayuk GS, Kanuri ND, Gyawali CP, et al. Opioid prescription use in United States Veterans with gastrointestinal symptoms. Gastroenterology. 2016;150:S315.CrossRef
38.
Choung RS, Locke GR, Zinsmeister AR, et al. Opioid bowel dysfunction and narcotic bowel syndrome: a population-based study. Am J Gastroenterol. 2009;104:1199–1204.CrossRefPubMedPubMedCentral
39.
Hirsch A, Yarur AJ, Dezheng H, et al. Penetrating disease, narcotic use, and loop ostomy are associated with ostomy and IBD-related complications after ostomy surgery in Crohn’s disease patients. J Gastrointest Surg.. 2015;19:1852–1861.CrossRefPubMed
40.
Lang G, Rojas JC, Hanauer SB. Factors predictive of 30-day readmissions in inflammatory bowel disease. Gastroenterology. 2013;144:S638.CrossRef
41.
Long MD, Barnes EL, Herfarth HH, et al. Narcotic use for inflammatory bowel disease and risk factors during hospitalization. Inflamm Bowel Dis. 2012;18:869–876.CrossRefPubMed
42.
Garland EL, Howard MO. Mindfulness-oriented recovery enhancement reduces pain attentional bias in chronic pain patients. Psychother Psychosom. 2013;82:311–318.CrossRefPubMed
43.
Click B, Anderson AM, Binion DG. Predicting costs of care for patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2016;15:393–395.CrossRefPubMed
44.
Arksey H, O’ Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8:19–32.CrossRef
45.
Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract. 1998;1:2–4.PubMed
46.
Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20:64–78.CrossRef
47.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, part 2. J Am Med Assoc. 2002;288:1909–1914.CrossRef
48.
Coleman K, Austin BT, Brach C, et al. Evidence on the chronic care model in the new millennium. Health Aff (Millwood). 2009;28:75–85.CrossRef
49.
50.
Lasser KE, Shanahan C, Parker V, et al. A multicomponent intervention to improve primary care provider adherence to chronic opioid therapy guidelines and reduce opioid misuse: a cluster randomized controlled trial protocol. J Subst Abuse Treat. 2016;60:101–109.CrossRefPubMed
51.
McEnvoy P, Barnes P. Using the chronic care model to tackle depression among older adults who have long-term physical conditions. J Psychiatr Ment Health Nurs. 2007;14:233–238.CrossRef
52.
Sohler NL, Li X, Kunins HV, et al. Home-versus office-based buprenorphine inductions for opioid-dependent patients. J Subst Abuse Treat. 2010;38:153–159.CrossRefPubMed
53.
Watkins K, Pincus HA, Tanielian TL, et al. Using the chronic care model to improve treatment of alcohol use disorders in primary care settings. J Stud Alcohol. 2003;64:209–218.CrossRefPubMed
54.
55.
Adams SG, Smith PK, Allan PF, et al. Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med. 2007;167:551–561.CrossRefPubMed
56.
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:1–9.CrossRef
57.
Schardt C, Adams MB, Owens T, et al. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7:1–6.CrossRef
58.
Crocker JA, Behm BW. Chronic narcotic use and misuse in inflammatory bowel disease: utilizing the prescription monitoring program in the outpatient setting. Gastroenterology. 2013;144:S774.CrossRef
59.
Crocker JA, Yu H, Conaway M, et al. Narcotic use and misuse in Crohn’s disease. Inflamm Bowel Dis. 2014;20:2234–2238.CrossRefPubMed
60.
Crocker J, Yu H, Tuskey A, et al. Functional gastrointestinal disorders are associated with high rates of chronic narcotic use and misuse in patients with Crohn’s disease. Inflamm Bowel Dis. 2013;19:S61–S62.CrossRef
61.
Katz N, Panas L, Kim M, et al. Usefulness of prescription monitoring programs for surveillance—analysis of Schedule II opioid prescription data in Massachusetts, 1996–2006. Pharmacoepidemiol Drug Saf. 2010;19:115–123.CrossRefPubMed
62.
Abraham A, Landrey AR, Swigris R. A painful journey. J Gen Intern Med. 2012;27:S356–S357.
63.
Sinha S, Callan EM, Akpunonu P, et al. How does use of a statewide prescription monitoring program affect emergency department prescribing behaviors? Ann Emerg Med. 2009;54:S14–S15.CrossRef
64.
Bahlani S, Mehta S, King A, et al. I-STOP/PMP: a tool for monitoring prescription drug abuse in patients with chronic pain syndromes. J Clin Urol. 2015;8:329–333.CrossRef
65.
Barth KS, Balliet W, Pelic CM, et al. Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain. Pain Med. 2014;15:1359–1364.CrossRefPubMedPubMedCentral
66.
Minkowitz HS, Scranton R, Gruschkus SK, et al. Development and validation of a risk score to identify patients at high risk for opioid-related adverse drug events. J Manag Care Pharm. 2014;20:948–958.
67.
Drossman DA, Morris CB, Edwards H, et al. Diagnosis, characterization, and 3-month outcome after detoxification of 39 patients with narcotic bowel syndrome. Am J Gastroenterol. 2012;107:1426–1440.CrossRefPubMed
68.
Brice M. Care plans for patients with frequent ED visits for such chief complaints as back pain, migraine, and abdominal pain. J Emerg Nurs. 2004;30:150-153.
69.
Bocelli L, Han S, Kheder J, et al. Assessment of lifestyle modifications in chronic pancreatitis patients. Am J Gastroenterol. 2014;109:S71.
70.
Meana M, Pruitt SD, Dresselhaus TR. Opioid therapy for chronic pancreatitis: controlling aberrant use through behavioral management. Gen Hosp Psychiatry. 1999;21:137.CrossRefPubMed
71.
Gregg J. A startling injustice: pain, opioids, and addiction. Ann Intern Med. 2015;162:651–652.CrossRefPubMed
72.
Frenk SM, Porter KS, Paulozzi LJ. Prescription opioid analgesic use among adults: United States, 1999–2012. National Center for Health Statistics Data Brief. 2015;189:1–8.
73.
Grunkemeier DM, Cassara JE, Dalton CB, et al. The narcotic bowel syndrome: clinical features, pathophysiology, and management. Clin Gastroenterol Hepatol. 2007;5:1126–1139.CrossRefPubMedPubMedCentral
74.
Kurlander JE, Drossman DA. Diagnosis and treatment of narcotic bowel syndrome. Nat Rev Gastroenterol Hepatol. 2014;11:410–418.CrossRefPubMed
75.
Chou R, Turner JA, Devine EB, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162:276–286.CrossRefPubMed
76.
Perrone J, Mycyk MB. A challenging crossroad for emergency medicine: the epidemics of pain and pain medication deaths. Acad Emerg Med. 2014;21:334–336.CrossRefPubMed
77.
Perrone J, Nelson LS. Medication reconciliation for controlled substances—an “ideal” prescription-drug monitoring program. New Engl J Med. 2012;366:2341–2343.CrossRefPubMed
78.
Smith PC, Schmidt SM, Allensworth-Davies D, et al. A single-question screening test for drug use in primary care. Arch Intern Med. 2010;170:1155–1160.PubMedPubMedCentral
79.
Fiellin D, Cutter CJ, Moore BA, et al. Primary care buprenorphine detoxification vs. maintenance for prescription opioid dependence. Drug Alcohol Depend. 2015;146:e277.
80.
Nosyk B, Li L, Evans E, et al. Utilization and outcomes of detoxification and maintenance treatment for opioid dependence in publicly-funded facilities in California, USA: 1991–2012. Drug Alcohol Depend. 2014;143:149–157.CrossRefPubMedPubMedCentral
81.
Moore SK, Guarino H, Acosta MC, et al. Patients as collaborators: using focus groups and feedback sessions to develop an interactive, web-based self-management intervention for chronic pain. Pain Med. 2013;14:1730–1740.CrossRefPubMed
82.
Nicholas MK, Blyth FM. Are self-management strategies effective in chronic pain treatment? Pain Manag. 2016;6:75–88.CrossRefPubMed
83.
Albert S, Brason II, Fred W, et al. Project Lazarus: community-based overdose prevention in rural North Carolina. Pain Med. 2011;12:S77–S85.CrossRefPubMed
84.
Kea B, Fu R, Lowe RA, et al. Interpreting the National Hospital Ambulatory Medical Care Survey: United States emergency department opioid prescribing, 2006–2010. Acad Emerg Med. 2016;23:159–165.CrossRefPubMedPubMedCentral
85.
Sack C, Phan VA, Grafton R, et al. A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease. J Crohn’s Colitis. 2012;6:302–310.CrossRef
86.
Argoff CE, Viscusi ER. The use of opioid analgesics for chronic pain: minimizing the risk for harm. Am J Gastroenterol Suppl.. 2014;2:3–8.CrossRefPubMed
87.
Starrels JL, Becker WC, Alford DP, et al. Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain. Ann Intern Med. 2010;152:712–720.CrossRefPubMed
88.
Volkow ND, McLellan AT. Opioid abuse in chronic pain—misconceptions and mitigation strategies. New Engl J Med. 2016;374:1253–1263.CrossRefPubMed
89.
Drossman DA. Beyond tricyclics: new ideas for treating patients with painful and refractory functional gastrointestinal symptoms. Am J Gastroenterol. 2009;104:2897–2902.CrossRefPubMed
90.
Keefer L, Mandal S. The potential role of behavioral therapies in the management of centrally mediated abdominal pain. Neurogastroenterol Motil. 2015;27:313–323.CrossRefPubMed
Metadaten
Titel
Strategies to Identify and Reduce Opioid Misuse Among Patients with Gastrointestinal Disorders: A Systematic Scoping Review
verfasst von
Salva N. Balbale
Itishree Trivedi
Linda C. O’Dwyer
Megan C. McHugh
Charlesnika T. Evans
Neil Jordan
Laurie A. Keefer
Publikationsdatum
05.08.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4705-9

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