Seilern Und Aspang Jesse, Schenker Mara L, Port Ada, Leslie Sharon, Giordano Nicholas A
Emory University School of Medicine, Department of Orthopaedic Surgery, Grady Memorial Hospital, Atlanta, GA.
Christopher Wolf Crusade, Atlanta, GA.
OTA Int. 2023 Jan 20;6(1):e226. doi: 10.1097/OI9.0000000000000226. eCollection 2023 Mar.
This systematic review evaluates the literature for patient-oriented opioid and pain educational interventions that aim to optimize pain management using opioid-sparing approaches in the orthopaedic trauma population. The study protocol was registered with PROSPERO (CRD42021234006).
A review of English-language publications in CINAHL (EBSCO), MEDLINE through PubMed, Embase.com, PsycInfo (EBSCO), and Web of Science Core Collection literature databases published between 1980 and February 2021 was conducted using PRISMA guidelines.
Only studies implementing patient-oriented opioid and/or pain education in adult patients receiving acute orthopaedic care were eligible. Outcomes were required to include postinterventional opioid utilization, postoperative analgesia and amount, or patient-reported pain outcomes.
A total of 480 abstracts were reviewed, and 8 publications were included in the final analysis. Two reviewers independently extracted data from selected studies using a standardized data collection form. Disagreements were addressed by a third reviewer. Quality of studies was assessed using the Cochrane Risk of Bias Tool.
Descriptive statistics characterized study findings, and content analysis was used to discern themes across studies.
Our findings indicate the merit for patient-centered educational interventions including verbal/written/audio-visual trainings paired with multimodal approaches to target opioid-sparing pain management and reduce short-term pain scores in urgent and acute care settings after acute orthopaedic injuries. The scarcity of published literature warrants further rigorously designed studies to substantiate the benefit of patient-centric education in reducing prolonged opioid utilization and associated risks after orthopaedic trauma.
Therapeutic level III.
本系统评价旨在评估以患者为导向的阿片类药物和疼痛教育干预措施的相关文献，这些干预措施旨在采用阿片类药物节省方法优化骨科创伤患者的疼痛管理。该研究方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42021234006）登记。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，检索了1980年至2021年2月期间发表在护理学与健康领域数据库（CINAHL，EBSCO平台）、通过PubMed检索的MEDLINE、Embase.com、心理学文摘数据库（PsycInfo，EBSCO平台）以及科学引文索引核心合集（Web of Science Core Collection）中的英文出版物。
仅纳入对接受急性骨科护理的成年患者实施以患者为导向的阿片类药物和/或疼痛教育的研究。结局指标要求包括干预后阿片类药物使用情况、术后镇痛及用量，或患者报告的疼痛结局。
共筛选了480篇摘要，最终纳入8篇出版物进行分析。两名评价员使用标准化数据收集表从选定研究中独立提取数据。分歧由第三名评价员解决。采用Cochrane偏倚风险工具评估研究质量。
采用描述性统计对研究结果进行描述，并通过内容分析识别各研究中的主题。
我们的研究结果表明，以患者为中心的教育干预措施具有价值，包括口头/书面/视听培训，并结合多模式方法，以实现阿片类药物节省的疼痛管理，并降低急性骨科损伤后紧急和急性护理环境中的短期疼痛评分。已发表文献的稀缺性表明，需要进一步开展设计严谨的研究，以证实以患者为中心的教育在减少骨科创伤后长期阿片类药物使用及相关风险方面的益处。
治疗性III级。
