Juravinski Hospital, Hamilton Health Sciences, 711 Concession Street, Hamilton, ON, L8V 1C1, Canada.
Mood Disorders Research Unit, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
Syst Rev. 2017 Aug 14;6(1):163. doi: 10.1186/s13643-017-0556-x.
Acute low back pain (ALBP) is the top cause of global disability, demonstrating a significant impact on individuals and society and demanding the need for appropriate management. There is a trend towards an increasing number of opioid prescriptions for ALBP despite the lack of investigation for its various short- and long-term outcomes. The objective of this review is to examine adverse outcomes associated with opioid use for ALBP.
METHODS/DESIGN: Using a search strategy, the search will be conducted using the following electronic databases: PubMed/MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Cochrane Library, the National Institutes for Health Clinical Trials Registry and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We will include randomized clinical trials and observational studies investigating the impact of opioid use in ALBP in the adult population. All phases of screening, data extraction and assessment of methodological quality will be performed by two independent reviewers. We will perform quality and risk of bias assessment for the included articles and compare high and low risk of bias with a sensitivity analysis. We will conduct random- and fixed-effects meta-analyses with heterogeneity calculated using the I statistic and evaluate publication bias.
There are current guidelines published to alert clinicians in prescribing opioids for ALBP due to its likelihood of misuse, yet there is little change in prescribing patterns. To date, there is an absence of systematic information about the outcomes of prescription opioid in patients with ALBP. We will address this gap by providing evidence that will be useful for clinical practice.
PROSPERO CRD42016033090.
急性腰痛（ALBP）是全球残疾的首要原因，对个人和社会都有重大影响，需要进行适当的管理。尽管缺乏对各种短期和长期结果的研究，但开具阿片类药物处方治疗 ALBP 的趋势却在增加。本综述的目的是研究阿片类药物治疗 ALBP 相关的不良结局。
方法/设计：使用搜索策略，将在以下电子数据库中进行搜索：PubMed/MEDLINE、EMBASE、PsycINFO、护理学和联合健康文献累积索引（CINAHL）、Web of Science、Cochrane 图书馆、美国国立卫生研究院临床试验注册处和世界卫生组织国际临床试验注册平台（WHO ICTRP）。我们将纳入调查阿片类药物治疗成人 ALBP 影响的随机临床试验和观察性研究。所有筛选、数据提取和方法学质量评估阶段均由两名独立评审员进行。我们将对纳入的文章进行质量和偏倚风险评估，并与敏感性分析比较高风险和低风险。我们将进行随机和固定效应荟萃分析，并使用 I 统计量计算异质性，评估发表偏倚。
目前已经发布了指南，提醒临床医生在开具阿片类药物治疗 ALBP 时要注意药物滥用的可能性，但处方模式几乎没有改变。迄今为止，关于阿片类药物处方治疗 ALBP 患者的结局，尚无系统信息。我们将通过提供对临床实践有用的证据来解决这一差距。
PROSPERO CRD42016033090。
