Check Devon K, Avecilla Renee A V, Mills Coleman, Dinan Michaela A, Kamal Arif H, Murphy Beverly, Rezk Salma, Winn Aaron, Oeffinger Kevin C
Department of Population Health Sciences, Duke University School of Medicine (D.K.C.), Durham, North Carolina; Duke Cancer Institute, Duke University Medical Cente (D.K.C., R.A.A., C.M., A.H.K., K.C.O.), Durham, North Carolina.
Duke Cancer Institute, Duke University Medical Cente (D.K.C., R.A.A., C.M., A.H.K., K.C.O.), Durham, North Carolina.
J Pain Symptom Manage. 2022 Apr;63(4):e397-e417. doi: 10.1016/j.jpainsymman.2021.10.015. Epub 2021 Nov 5.
Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear.
To provide an evidence synthesis.
We searched PubMed and Embase, identifying articles related to cancer, and opioid prescribing/use published through September 2020. We screened resulting titles/abstracts. Relevant studies underwent full-text review. Inclusion criteria were quantitative examination of and primary focus on opioid prescribing or use, and explicit inclusion of cancer survivors. Exclusion criteria included end-of-life opioid use and opioid use as a secondary or downstream outcome (for intervention studies). We extracted information on the opioid-related outcome(s) examined (including definitions and terminology used), study design, and methods.
Research returned 16,591 articles; 296 were included. Only 22 of 296 studies evaluated an intervention. There were 105 studies evaluating outcomes indicative of potentially high-risk, nonrecommended, or avoidable opioid use, e.g., continuous use-described as chronic use, prolonged use, and persistent use (n = 17); use after completion of curative-intent treatment-described as chronic opioid use, long-term opioid use, persistent opioid use, prolonged opioid use, continued opioid use, late opioid use, post-treatment opioid use (n = 27); use of opioids concurrent with other potentially high-risk medications (n = 13), and opioid misuse (n = 14).
We found lack of consistency in the measurement of and terms used to describe similar opioid use outcomes, and a lack of interventional research targeting well-documented patterns of potentially nonrecommended, potentially avoidable, or potentially high-risk opioid prescribing or use.
近年来，癌症幸存者中阿片类药物使用的研究急剧增加，但缺乏证据综合分析，存在知识空白。相应的研究需求尚不清楚。
进行证据综合分析。
我们检索了PubMed和Embase，识别截至2020年9月发表的与癌症以及阿片类药物处方/使用相关的文章。我们筛选了所得的标题/摘要。对相关研究进行全文审查。纳入标准为对阿片类药物处方或使用进行定量检查且主要关注于此，以及明确纳入癌症幸存者。排除标准包括临终时使用阿片类药物以及作为次要或下游结局的阿片类药物使用（干预研究）。我们提取了有关所检查的阿片类药物相关结局（包括所使用的定义和术语）、研究设计和方法的信息。
检索到16591篇文章；纳入296篇。296项研究中只有22项评估了干预措施。有105项研究评估了表明可能存在高风险、不推荐或可避免的阿片类药物使用的结局，例如持续使用——被描述为慢性使用、长期使用和持续使用（n = 17）；根治性治疗完成后使用——被描述为慢性阿片类药物使用、长期阿片类药物使用、持续阿片类药物使用、长期阿片类药物使用、持续阿片类药物使用、晚期阿片类药物使用、治疗后阿片类药物使用（n = 27）；与其他潜在高风险药物同时使用阿片类药物（n = 13），以及阿片类药物滥用（n = 14）。
我们发现，在测量和描述类似阿片类药物使用结局的术语方面缺乏一致性，并且缺乏针对有充分记录的可能不推荐、可能可避免或可能高风险的阿片类药物处方或使用模式的干预研究。
