University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Punches and Clark); Departments of Emergency Medicine (Drs Punches, Freiermuth, and Lyons) and Psychiatry and Behavioral Neuroscience (Dr Brown), University of Cincinnati College of Medicine, Cincinnati, Ohio; and UC Health, Cincinnati, Ohio (Dr Alhaj Ali).
Adv Emerg Nurs J. 2021;43(4):331-343. doi: 10.1097/TME.0000000000000377.
Efforts to minimize the impact of prescribed opioids on future adverse outcomes are reliant on emergency care providers' ability to screen and detect opioid use disorder (OUD). Many prescriptions are initiated in the emergency department (ED) for acute pain; thus, validated measures are especially needed. Our systematic review describes the available opioid-related screening measures identified through search of the available literature. Measures were categorized by intent and applied clinical setting. We found 44 articles, identifying 15 screening measures. Of these, nine were developed to screen for current opioid misuse and five to screen for risk of future opioid misuse. None were created for use outside of a chronic pain setting. Many measures were applied differently from intended purpose. Although several measures are available, screening for adverse opioid outcomes in the ED is hampered by lack of validated instruments. Development of clarified conceptual models and ED-specific research is necessary to limit OUD.
努力将处方阿片类药物对未来不良后果的影响降到最低，这依赖于急救护理提供者筛查和发现阿片类药物使用障碍（OUD）的能力。许多处方是在急诊科为急性疼痛开具的；因此，特别需要经过验证的方法。我们的系统综述描述了通过搜索现有文献确定的可用的与阿片类药物相关的筛查方法。这些方法按目的和应用的临床环境进行分类。我们发现了 44 篇文章，确定了 15 种筛查方法。其中，有 9 种是为筛查当前阿片类药物滥用而开发的，5 种是为筛查未来阿片类药物滥用风险而开发的。没有一种是为在慢性疼痛环境之外使用而创建的。许多方法的应用与预期目的不同。尽管有几种方法可用，但在急诊科筛查不良阿片类药物结果受到缺乏经过验证的工具的阻碍。为了限制 OUD，有必要制定明确的概念模型和针对急诊科的具体研究。
