• Pain Med · Aug 2023

    Interdisciplinary Strategies to Prevent Long-Term and Detrimental Opioid Use Following Trauma: A Stakeholder Consensus Study.

    • Mélanie Bérubé, Caroline Côté, Marc-Aurèle Gagnon, Lynne Moore, Lorraine Tremblay, Alexis F Turgeon, David Evans, Greg Berry, Valérie Turcotte, Étienne L Belzile, Craig Dale, Eli Orrantia, Michael Verret, Judy Dercksen, Marc-Olivier Martel, Sébastien Dupuis, Claude-Edouard Chatillon, and François Lauzier.
    • CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma-Emergency-Critical Care Medicine), Québec City, Quebec G1V 0A6, Canada.
    • Pain Med. 2023 Aug 1; 24 (8): 933940933-940.

    ObjectiveProlonged opioid use is common following traumatic injuries. Although preventive strategies have been recommended, the evidence supporting their use is low. The objectives of this study were to select interdisciplinary strategies to prevent long-term, detrimental opioid use in trauma patients for further evaluation and to identify implementation considerations.DesignA consensus study using the nominal group technique.SettingFour trauma systems in Canada.SubjectsParticipants included expert clinicians and decision makers, and people with lived experience.MethodsParticipants had to discuss the relevance and implementation of 15 strategies and then rank them using a 7-point Likert scale. Implementation considerations were identified through a synthesis of discussions.ResultsA total of 41 expert stakeholders formed the nominal groups. Overall, eight strategies were favored: 1) using multimodal approach for pain management, 2) professional follow-up in physical health, 3) assessment of risk factors for opioid misuse, 4) physical stimulation, 5) downward adjustment of opioids based on patient recovery, 6) educational intervention for patients, 7) training offered to professionals on how to prescribe opioids, and 8) optimizing communication between professionals working in different settings. Discussions with expert stakeholders revealed the rationale for the selected strategies and identified issues to consider when implementing them.ConclusionThis stakeholder consensus study identified, for further scientific study, a set of interdisciplinary strategies to promote appropriate opioid use following traumatic injuries. These strategies could ultimately decrease the burden associated with long-term opioid use.© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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