• Sheryl Spithoff, Stephanie Mathieson, Frank Sullivan, Qi Guan, Abhimanyu Sud, Susan Hum, and Mary Ann O'Brien.
• From the Department of Family and Community Medicine, University of Toronto, Toronto, Canada (SS); Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney; Sydney, Australia (SM); University of St Andrews; St Andrews, United Kingdom (FS); Department of Family and Community Medicine, University of Toronto; Toronto, Canada (FS); Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (QG); Department of Family and Community Medicine; Medical Psychiatry Alliance; Institute of Health Policy, Management and Evaluation, University of Toronto; Toronto, Canada (AS); Department of Family and Community Medicine, Women's College Hospital; Toronto, Canada (SH); Department of Family and Community Medicine, University of Toronto; Women's College Research Institute; Toronto, Canada (MAO). sheryl.spithoff@wchospital.ca.
• J Am Board Fam Med. 2020 Jul 1; 33 (4): 529-540.

Background And ObjectivesClinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions.MethodsWe searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019. Two reviewers independently screened the citations. One reviewer extracted data and a second verified for accuracy.Inclusion Criteriastudy of a CDSS for opioid prescribing for CNCP in a primary care clinical setting. We reported quantitative results in tables and qualitative results in narrative form.ResultsOur search yielded 5068 records, of which 14 studies met our inclusion criteria. All studies were conducted in the United States. Six studies examined local (eg, health center) CDSSs and 8 examined prescription drug monitoring program CDSSs. Three CDSSs incorporated evidence-based components. Study aims were heterogeneous and study designs included both quantitative and qualitative methodologies. No studies assessed patient health outcomes. Few studies appeared to be following guidance for evaluating complex interventions.ConclusionsFew studies have rigorously assessed the use of CDSSs for opioid prescribing for CNCP in primary care settings. Going forward, investigators should include evidence-based components into the design of CDSSs and follow guidance for the development and evaluation of complex interventions.© Copyright 2020 by the American Board of Family Medicine.

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