Korownyk Christina, Perry Danielle, Ton Joey, Kolber Michael R, Garrison Scott, Thomas Betsy, Allan G Michael, Bateman Cheryl, de Queiroz Raquel, Kennedy Dorcas, Lamba Wiplove, Marlinga Jazmin, Mogus Tally, Nickonchuk Tony, Orrantia Eli, Reich Kim, Wong Nick, Dugré Nicolas, Lindblad Adrienne J
Family physician and Associate Professor in the Department of Family Medicine at the University of Alberta in Edmonton.
Nurse and Clinical Evidence Expert at the Alberta College of Family Physicians in Edmonton.
Can Fam Physician. 2019 May;65(5):321-330.
To use the best available evidence and principles of shared, informed decision making to develop a clinical practice guideline for a simplified approach to managing opioid use disorder (OUD) in primary care.
Eleven health care and allied health professionals representing various practice settings, professions, and locations created a list of key questions relevant to the management of OUD in primary care. These questions related to the treatment setting, diagnosis, treatment, and management of comorbidities in OUD. The questions were researched by a team with expertise in evidence evaluation using a series of systematic reviews of randomized controlled trials. The Guideline Committee used the systematic reviews to create recommendations.
Recommendations outline the role of primary care in treating patients with OUD, as well as pharmacologic and psychotherapy treatments and various prescribing practices (eg, urine drug testing and contracts). Specific recommendations could not be made for management of comorbidities in patients with OUD owing to limited evidence.
The recommendations will help simplify the complex management of patients with OUD in primary care. They will aid clinicians and patients in making informed decisions regarding their care.
运用现有最佳证据和共同的、充分知情决策原则，制定一项关于在初级保健中简化阿片类物质使用障碍（OUD）管理方法的临床实践指南。
11名代表不同执业环境、专业和地点的医疗保健及相关健康专业人员列出了与初级保健中OUD管理相关的关键问题清单。这些问题涉及OUD的治疗环境、诊断、治疗以及共病管理。由具有证据评估专业知识的团队通过一系列随机对照试验的系统评价对这些问题进行研究。指南委员会利用这些系统评价制定建议。
建议概述了初级保健在治疗OUD患者中的作用，以及药物治疗和心理治疗及各种处方做法（如尿液药物检测和协议）。由于证据有限，无法针对OUD患者的共病管理提出具体建议。
这些建议将有助于简化初级保健中OUD患者的复杂管理。它们将帮助临床医生和患者就其治疗做出明智决策。
