Marshall Tyler, Kinnard Elizabeth N, Hancock Myles, King-Jones Susanne, Olson Karin, Abba-Aji Adam, Rittenbach Katherine, Vohra Sunita
Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Department of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, United States of America.
BMJ Open. 2018 Oct 17;8(10):e022267. doi: 10.1136/bmjopen-2018-022267.
Opioid use disorder (OUD) is characterised by the fifth Edition of the Diagnostic and Statistics Manual as a problematic pattern of opioid use (eg, fentanyl, heroin, oxycodone) that leads to clinically significant impairment. OUD diagnoses have risen substantially over the last decade, and treatment services have struggled to meet the demand. Evidence suggests when patients with chronic illnesses are matched with their treatment preferences and engaged in shared decision-making (SDM), health outcomes may improve. However, it is not known whether SDM could impact outcomes in specific substance use disorders such as OUD.
A scoping review will be conducted according to Arksey and O'Malley's framework and by recommendations from Levac . The search strategy was developed to retrieve relevant publications from database inception and June 2017. MEDLINE, EMBASE, PsycINFO, Cochrane Database for Controlled Trials, Cochrane Database for Systematic Reviews and reference lists of relevant articles and Google Scholar will be searched. Included studies must be composed of adults with a diagnosis of OUD, and investigate SDM or its constituent components. Experimental, quasi-experimental, qualitative, case-control, cohort studies and cross-sectional surveys will be included. Articles will be screened for final eligibility according to title and abstract, and then by full text. Two independent reviewers will screen excluded articles at each stage. A consultation phase with expert clinicians and policy-makers will be added to set the scope of the work, refine research questions, review the search strategy and identify additional relevant literature. Results will summarise whether SDM impacts health and patient-centred outcomes in OUD.
Scoping review methodology is considered secondary analysis and does not require ethics approval. The final review will be submitted to a peer-reviewed journal, disseminated at relevant academic conferences and will be shared with policy-makers, patients and clinicians.
《精神疾病诊断与统计手册》第五版将阿片类物质使用障碍（OUD）定义为一种有问题的阿片类物质使用模式（例如，芬太尼、海洛因、羟考酮），会导致临床上的显著损害。在过去十年中，OUD的诊断数量大幅上升，治疗服务难以满足需求。有证据表明，当慢性病患者的治疗偏好得到匹配，并参与共同决策（SDM）时，健康结果可能会改善。然而，尚不清楚SDM是否会影响诸如OUD等特定物质使用障碍的治疗结果。
将根据阿克西和奥马利的框架以及莱瓦克的建议进行一项范围综述。制定检索策略以检索自数据库建立至2017年6月的相关出版物。将检索MEDLINE、EMBASE、PsycINFO、Cochrane对照试验数据库、Cochrane系统评价数据库以及相关文章的参考文献列表和谷歌学术。纳入的研究必须由诊断为OUD的成年人组成，并调查SDM或其组成部分。将纳入实验性、准实验性、定性、病例对照、队列研究和横断面调查。将根据标题和摘要，然后根据全文筛选文章以确定最终的合格性。两名独立的评审员将在每个阶段筛选排除的文章。将增加一个与专家临床医生和政策制定者的咨询阶段，以确定工作范围、完善研究问题、审查检索策略并识别其他相关文献。结果将总结SDM是否会影响OUD患者的健康和以患者为中心的结果。
范围综述方法被视为二次分析，不需要伦理批准。最终综述将提交给同行评审期刊，在相关学术会议上传播，并将与政策制定者、患者和临床医生分享。
