Clinical Decision Support Systems for Opioid Prescribing for Chronic Non-Cancer Pain in Primary Care: A Scoping Review
Open accessAbstract
BACKGROUND AND OBJECTIVES: Clinical 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. METHODS: We 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 CRITERIA: study 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. RESULTS: Our 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. CONCLUSIONS: Few 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.
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Clinical decision support systems for opioid prescribing for chronic non-cancer pain in primary care have underutilization of evidence-based designs, heterogeneity in study designs, and lack of assessment of patient health outcomes.
“Spithoff etal. examined clinical decision support systems (CDS) for opioid prescribing for chronic non-cancer pain in primary care and observed underutilization of evidence-based designs of CDS, heterogeneity in study designs, and lack of assessment of patient health outcomes. 8”
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The benefits of a standardized approach to opioid prescribing.
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Coleman, C. (2015) · Aquila Digital Community (University of Southern Mississippi) · Cited by 2 · see citing works
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Assessing the use of a clinical decision support tool for pain management in primary care
Apathy, N. C., Sanner, L., Adams, M. C. B., Mamlin, B. W., Grout, R. W., Fortin, S., Hillstrom, J., Saha, A., Teal, E., Vest, J. R., et al. (2022) · JAMIA Open · doi:10.1093/jamiaopen/ooac074 · Cited by 9 · see citing works
Price-Haywood, E. G., Burton, J. H., Harden-Barrios, J., Bazzano, A., Shi, L., Lefante, J., & Jamison, R. N. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-024-08965-7 · Cited by 2 · see citing works
- Authors
- Spithoff, S., Mathieson, S., Sullivan, F., Guan, Q., Sud, A., Hum, S., & O'Brien, M. A.
- Affiliations
- The University of Sydney (AU)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2020-07
- Volume
- 33
- Issue
- 4
- Pages
- 529-540
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W3042247714
- Cited by
- 25
- References
- 97
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 4 · 2022: 8 · 2021: 2 · 2020: 1
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- St Andrews Research Repository (St Andrews Research Repository) (submittedVersion)
- Funders
- Medical Psychiatry Alliance
- University of Toronto
- North York General Hospital
- Medical Research Council
- National Health and Medical Research Council (1158463)
- Department of Family and Community Medicine, University of Toronto
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- clinical decision support systems, opioid prescribing, chronic non-cancer pain, primary care, prescription drug monitoring programs, complex interventions, intervention evaluation, patient outcomes
- MeSH terms
- Analgesics, Opioid, Humans, Practice Patterns, Physicians', Primary Health Care, United States, Decision Support Systems, Clinical, Chronic Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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