Faculty of Medicine, School of Physical and Occupational Therapy, Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
McGill University Health Centre, Montreal, Quebec, Canada.
Syst Rev. 2021 Feb 9;10(1):53. doi: 10.1186/s13643-021-01596-7.
Chronic pain is a common public health problem with negative consequences for individuals and societies. Fortunately, interdisciplinary chronic pain management has been shown to be effective for improving patients' outcomes and strongly recommended in clinical practice guidelines. Appropriate referral within the healthcare system based on individuals' needs and available services is essential to optimise health-related outcomes and maximise resources. Clinical decision support systems have been shown to be effective for supporting healthcare professionals in different practices. However, there is no knowledge synthesis on clinical decision support systems for referral within chronic pain practice. We aim to identify the clinical decision support systems for referral within chronic pain practices and assess their content, effectiveness, harms, and validation parameters.
Using the methodology of Cochrane reviews, we will perform a systematic review and meta-analysis based on studies meeting the following criteria: Population, patients with chronic pain and/or healthcare professionals working in chronic pain; Intervention, clinical decision support systems for referral within chronic pain practice; Comparison, any other clinical tool, any usual care or practices; Outcomes, clinical outcomes of patients measuring how patients feel, function or survive including benefits, adverse effects, continuity of care, care appropriateness, care satisfaction, quality of life, healthcare professional performance, and cost outcomes; and Study design: randomized controlled trials, non-randomized controlled trials, before and after controlled studies and interrupted time series. We will search relevant literature with the support of an information specialist using Medline, Embase, PsycInfo, CINHAL, Web of Science and Cochrane Library from their inception onwards. Two reviewers will independently complete study selection, data extraction and risk of bias assessment. We will analyse data to perform both narrative syntheses and meta-analysis if appropriate.
Findings of this review will contribute to enhancing chronic pain care and research. Clinical decision support systems identified as effective in this review can be investigated for implementation in clinical practice and impact on improving patient, clinical and health system outcomes. Clinical decision support systems not yet ready for implementation that require further improvement will also be identified.
PROSPERO registration: CRD42020158880 .
慢性疼痛是一个常见的公共卫生问题，会给个人和社会带来负面影响。幸运的是，跨学科慢性疼痛管理已被证明能有效改善患者的预后，并在临床实践指南中得到强烈推荐。根据个人的需求和可用服务，在医疗保健系统内进行适当的转介对于优化健康相关结果和最大限度地利用资源至关重要。临床决策支持系统已被证明可有效支持不同实践中的医疗保健专业人员。然而，目前尚无关于慢性疼痛实践中转介的临床决策支持系统的知识综合。我们的目标是确定慢性疼痛实践中转介的临床决策支持系统，并评估其内容、有效性、危害和验证参数。
使用 Cochrane 综述的方法，我们将基于符合以下标准的研究进行系统评价和荟萃分析：人群，患有慢性疼痛的患者和/或在慢性疼痛中工作的医疗保健专业人员；干预措施，慢性疼痛实践中的临床决策支持系统转介；比较，任何其他临床工具，任何常规护理或实践；结局，衡量患者感受、功能或生存的患者临床结局，包括获益、不良反应、护理连续性、护理适宜性、护理满意度、生活质量、医疗保健专业人员绩效和成本结果；以及研究设计：随机对照试验、非随机对照试验、前后对照研究和中断时间序列研究。我们将在信息专家的支持下，使用 Medline、Embase、PsycInfo、CINHAL、Web of Science 和 Cochrane Library 从其成立开始搜索相关文献。两名审查员将独立完成研究选择、数据提取和偏倚风险评估。我们将分析数据以进行叙述性综合和荟萃分析（如果合适）。
本综述的结果将有助于加强慢性疼痛护理和研究。本综述中确定为有效的临床决策支持系统可用于调查其在临床实践中的实施情况及其对改善患者、临床和卫生系统结果的影响。还将确定那些尚未准备好实施但需要进一步改进的临床决策支持系统。
PROSPERO 注册：CRD42020158880。
