Effectiveness of interventions for prevention of common infections in people who use opioids: a protocol for a systematic review of systematic reviews
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Abstract
Background: The North American opioid crisis is driven by opioid-related mortality and morbidity, including opioid use-associated infections (OUAIs), resulting in a substantial burden for society. Users of legal and illegal opioids are at an increased risk of OUAIs compared to individuals not using opioids. As reported for hepatitis C virus (HCV), human immunodeficiency virus (HIV), bacterial, fungal, and other infections, OUAIs transmission and acquisition risks may be modifiable. Several systematic reviews (SRs) synthetized data regarding interventions to prevent infections in persons using drugs (e.g., opioid substitution therapy, needle and syringes exchange programs, psycho-social interventions); however, their conclusions varied. Therefore, SR of published SRs is needed to synthesize the highest level of evidence on the scope and effectiveness of interventions to prevent OUAIs in people using opioids legally or illegally. Methods: We will comprehensively search for SRs in the PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Epistemonikos, and Google Scholar databases from inception to November 2020. Data selection and extraction for each SR will be performed independently by two researchers, with disagreements resolved by consensus. All SRs regarding interventions with evaluated effectiveness to prevent OUAI in legal and/or illegal opioid users will be eligible. Risk of bias assessment will be performed using the AMSTAR2 tool. The results will be qualitatively synthesized, and a typology of interventions’ effectiveness with a statement on the strength of evidence for each category will be created. Discussion: Our pilot search of PubMed resulted in 379 SRs analyzing the effectiveness of interventions to prevent HCV and HIV in persons who inject different types of drugs, including opioids. Of these 379 SRs, 8 evaluated primary studies where participants used opioids and would therefore be eligible for inclusion. The search results thus justify the application of SR of SRs approach. Comprehensive data on the scope and effectiveness of existing interventions to prevent OUAIs will help policy-makers to plan and implement preventive interventions and will assist clinicians in the guidance for their patients using opioids. Systematic review registration: Registered in PROSPERO on 30 July 2020 ( #195929 ).
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Distribution of sterile injecting equipment through syringe services programs is effective for preventing HIV and HCV infections.
“The distribution of sterile injecting equipment through syringe services programs is an effective intervention for preventing HIV and hepatitis C virus (HCV) infections 261 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [261]
The Background and Discussion describe a planned review of interventions to prevent HIV and HCV, but do not report whether syringe services programs are effective. The References list reviews about sterile injecting equipment and needle–syringe programs; their titles do not establish the claimed finding in this paper. Searches for sterile injecting equipment, syringe services programs, and their effectiveness found no decisive passage. (LLM, conf=0.74)
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Kudrina, I., Pagé, M. G., Choinière, M., Shir, Y., Eisenberg, M. J., Ben-Sasson, M., Lebouché, B., & Puzhko, S. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-083791 · Cited by 2 · see citing works
Self-citation
- Authors
- Kudrina, I., Puzhko, S., Filion, K. B., Gore, G., Paraskevopoulos, E., Windle, S., Martel, M. O., & Eisenberg, M. J.
- Affiliations
- McGill University (CA)
- McGill University Health Centre (CA)
- Queensway-Carleton Hospital (CA)
- Jewish General Hospital (CA)
- Corresponding author
- Kudrina, Irina
- ORCID
- Venue
- Systematic Reviews
- Published
- 2021-11-15
- Volume
- 10
- Issue
- 1
- Pages
- 298-298
- ISSN
- 2046-4053 (ISSN-L)
- PMC
- PMC8591821
- OpenAlex
- W3117054297
- Cited by
- 4
- References
- 52
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 0.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Systematic Reviews (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research (#EOC-162067)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- people who use opioids, infection prevention interventions, opioid substitution therapy, psychosocial interventions, hepatitis C, HIV, opioid use disorder, harm reduction
- MeSH terms
- Systematic Reviews as Topic, Analgesics, Opioid, Hepatitis C, Humans, Opioid-Related Disorders, Opiate Substitution Treatment
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