• Can J Anaesth · Jan 2023

    Strategies to prevent long-term opioid use following trauma: a Canadian practice survey.

    • Mélanie Bérubé, Caroline Côté, Lynne Moore, Alexis F Turgeon, Étienne L Belzile, Andréane Richard-Denis, Craig M Dale, Gregory Berry, Manon Choinière, Gabrielle M Pagé, Line Guénette, Sébastien Dupuis, Lorraine Tremblay, Valérie Turcotte, Marc-Olivier Martel, Claude-Édouard Chatillon, Kadija Perreault, and François Lauzier.
    • Population Health and Optimal Practices Research Unit Research Unit (Trauma - Emergency-Critical Care Medicine), CHU de Québec-Université Laval Research Centre, 1401, 18e rue, Quebec City, QC, G1V 1Z4, Canada. melanie.berube@fsi.ulaval.ca.
    • Can J Anaesth. 2023 Jan 1; 70 (1): 879987-99.

    PurposeTo evaluate how Canadian clinicians involved in trauma patient care and prescribing opioids perceive the use and effectiveness of strategies to prevent long-term opioid therapy following trauma. Barriers and facilitators to the implementation of these strategies were also assessed.MethodsWe conducted a web-based cross-sectional survey. Potential participants were identified by trauma program managers and directors of the targeted departments in three Canadian provinces. We designed our questionnaire using standard health survey research methods. The questionnaire was administered between April 2021 and November 2021.ResultsOur response rate was 47% (350/744), and 52% (181/350) of participants completed the entire survey. Most respondents (71%, 129/181) worked in teaching hospitals. Multimodal analgesia (93%, 240/257), nonsteroidal anti-inflammatory agents (77%, 198/257), and physical stimulation (75%, 193/257) were the strategies perceived to be the most frequently used. Several preventive strategies were perceived to be very effective by over 80% of respondents. Of these, some that were reported as not being frequently used were perceived to be among the most effective ones, including guidelines or protocols, assessing risk factors for opioid misuse, physical health follow-up by a professional, training for clinicians, patient education, and prescription monitoring systems. Staff shortages, time constraints, and organizational practices were identified as the main barriers to the implementation of the highest ranked preventive strategies.ConclusionsSeveral strategies to prevent long-term opioid therapy following trauma are perceived as being effective by those prescribing opioids in this population. Some of these strategies appear to be commonly used in everyday practice and others less so. Future research should focus on which preventive strategies should be given higher priority for implementation before assessing their effectiveness.© 2022. Canadian Anesthesiologists' Society.

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