Grant: Operating Grant: Opioid Crisis Knowledge Synthesis

Opioids are commonly used to manage acute pain s. For many patients, opioid therapy, initially intended to be short-term, becomes prolonged. In fact, among patients on opioid therapy for more than 90 days, more than half of them continue to use opioids years later. This prolonged opioid therapy can lead to harmful side effects and carry a risk of abuse/misuse/dependency. In this context, it is important to understand how opioid therapy becomes prolonged so we can reduce its occurrence. Surgical and trauma populations are ideal to study such phenomenon since onset of opioid therapy is known and measures can be collected before, during and after. Scientific knowledge on this topic is varied and difficult to integrate into a comprehensive and meaningful framework. The objectives of this study is to synthesize, using a systematic review protocol, scientific knowledge on incidence and risk factors for prolonged opioid therapy among patients who have undergone any type of surgery or experienced trauma. The systematic review methodology follows recommendations from Preferred ReportIng Systematic Reviews and Meta-Analysis (PRISMA) statements on the conduct of systematic review and meta-analysis and the MOOSE Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies. The following steps will be undertaken: defining eligibility criteria, identification of potentially eligible studies, study selection, data extraction and management, critical appraisal and data analysis and synthesis. This review will contribute to the prevention and harm reduction strategies associated with prescribed opioids. The identification of common risk factors for prolonged opioid therapy will help orient further research on the topic and offer key therapeutic targets for prevention strategies for prolonged opioid therapy. This will allow for cost-effective optimization of patient monitoring in the weeks following therapy initiation and for the design of risk prevention programs.