Nathaniel M Murray1, Krishan Yadav2,3, Raoul Daoust4,5, Daniel James2, Avik Nath2, Roland Halil2, Moaweya Zayed2, Debra Eagles2,3. 1. The University of Ottawa, Ottawa, ON, Canada. nmurray@toh.ca. 2. The University of Ottawa, Ottawa, ON, Canada. 3. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 4. Universite de Montreal, Montreal, QC, Canada. 5. CIUSSS Nord-de-L'ile, Ottawa, ON, Canada.
Abstract
OBJECTIVES: Currently, there are no Canadian guidelines for discharge instruction to be given to patients receiving an opioid prescription in the ED. This likely contributes to inadequate discharge instructions for these potentially dangerous medications. The principal goal of this study was to develop an interdisciplinary Canadian consensus regarding important concepts to be included in written opioid discharge instructions within the ED setting. METHODS: We conducted a modified Delphi study between May and August 2021. The national multidisciplinary panel consisted of 23 healthcare professionals and one patient partner. The survey consisted of 19 initial concepts developed after a review of the literature and a meeting with local experts. The panel added four new concepts after the first survey round. Three rounds of online surveys were distributed in total. Panel consensus was defined a priori as a disagreement index score less than 1, in accordance with the RAND/UCLA Appropriateness Method. RESULTS: We achieved a 100% response rate in round one and a 96% response rate in rounds two and three of our Delphi study. There was group consensus (disagreement index = 0.66, median importance = 9) that all patients receiving opioid prescriptions from the ED should receive written discharge instructions. The interdisciplinary panel arrived at a consensus on 21/23 concepts for ED opioid discharge instructions. The concepts with the highest level of agreement were related to minimizing the use of the prescribed opioid medication and opioid use safety (mixing with drugs/alcohol, storage, and impairment). CONCLUSION: This Delphi study with a national, multidisciplinary panel achieved consensus on 21 concepts that should be included in written discharge instructions to patients receiving an opioid prescription upon discharge from the ED.
OBJECTIVES: Currently, there are no Canadian guidelines for discharge instruction to be given to patients receiving an opioid prescription in the ED. This likely contributes to inadequate discharge instructions for these potentially dangerous medications. The principal goal of this study was to develop an interdisciplinary Canadian consensus regarding important concepts to be included in written opioid discharge instructions within the ED setting. METHODS: We conducted a modified Delphi study between May and August 2021. The national multidisciplinary panel consisted of 23 healthcare professionals and one patient partner. The survey consisted of 19 initial concepts developed after a review of the literature and a meeting with local experts. The panel added four new concepts after the first survey round. Three rounds of online surveys were distributed in total. Panel consensus was defined a priori as a disagreement index score less than 1, in accordance with the RAND/UCLA Appropriateness Method. RESULTS: We achieved a 100% response rate in round one and a 96% response rate in rounds two and three of our Delphi study. There was group consensus (disagreement index = 0.66, median importance = 9) that all patients receiving opioid prescriptions from the ED should receive written discharge instructions. The interdisciplinary panel arrived at a consensus on 21/23 concepts for ED opioid discharge instructions. The concepts with the highest level of agreement were related to minimizing the use of the prescribed opioid medication and opioid use safety (mixing with drugs/alcohol, storage, and impairment). CONCLUSION: This Delphi study with a national, multidisciplinary panel achieved consensus on 21 concepts that should be included in written discharge instructions to patients receiving an opioid prescription upon discharge from the ED.
Authors: Mir M Ali; Eli Cutler; Ryan Mutter; Rachel Mosher Henke; Maryann Mazer-Amirshahi; Jesse M Pines; Nicholas Cummings Journal: Drug Alcohol Depend Date: 2019-10-17 Impact factor: 4.492
Authors: Ian A Donaldson; Roberto Alonzi; Dean Barratt; Eric Barret; Viktor Berge; Simon Bott; David Bottomley; Scott Eggener; Behfar Ehdaie; Mark Emberton; Richard Hindley; Tom Leslie; Alec Miners; Neil McCartan; Caroline M Moore; Peter Pinto; Thomas J Polascik; Lucy Simmons; Jan van der Meulen; Arnauld Villers; Sarah Willis; Hashim U Ahmed Journal: Eur Urol Date: 2014-10-01 Impact factor: 20.096