Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR, USA.
Stud Health Technol Inform. 2022 Jun 6;290:447-451. doi: 10.3233/SHTI220115.
Approximately 2 million Americans live with opioid use disorder (OUD), most of whom also have chronic pain. The economic burden of chronic pain and prescription opioid misuse runs into billions of dollars. Patients on prescription opioids for chronic non-cancer pain (CNCP) are at increased risk for OUD and overdose. By adhering to the Center for Disease Control and Prevention (CDC) opioid prescribing guidelines, primary care providers (PCPs) have the potential to improve patient outcomes. But numerous provider, patient, and practice-specific factors challenge adherence to guidelines in primary care. Many of the barriers may be mediated by informatics interventions, but gaps in knowledge and unmet needs exist. This narrative review examines the risk assessment and harm reduction process in a socio-technical context to highlight the gaps in knowledge and unmet needs that can be mediated through informatics intervention.
大约有 200 万美国人患有阿片类药物使用障碍(OUD),其中大多数人也患有慢性疼痛。慢性疼痛和处方类阿片类药物滥用给美国造成的经济负担高达数十亿美元。因慢性非癌症疼痛(CNCP)而开处方类阿片类药物的患者,有更高的 OUD 和用药过量风险。初级保健提供者(PCPs)如果遵循疾病控制与预防中心(CDC)的阿片类药物处方指南,就有可能改善患者的治疗效果。但许多提供者、患者和特定实践因素都对初级保健中遵循指南构成了挑战。许多障碍可能可以通过信息学干预来解决,但仍存在知识差距和未满足的需求。本叙述性综述从社会技术背景出发,考察了风险评估和减少伤害的过程,以突出信息学干预可以解决的知识差距和未满足的需求。