Published by Jason Busse Associate Professor, Department of Anesthesia, Associate Professor, Department of Health Research Methods, Evidence and Impact McMaster University, HSC-2V9, 1280 Main St. West, Hamilton, Ontario, Canada, L8S 4K1 bussejw@mcmaster.ca on Sep 28, 2017
Disclaimer
Ces lignes directrices sont issues d’une étude réalisée à l’initiative de chercheurs, subventionnée grâce à des bourses des Instituts de recherche en santé du Canada et de Santé Canada. Les bailleurs de fonds n’ont joué aucun rôle dans la conception ou la réalisation de l’étude; la collecte, l’analyse et l’interprétation des données; ou la préparation, la révision ou l’approbation des lignes directrices. Le personnel de Santé Canada a émis des commentaires non contraignants au cours de l’étude. Les décisions finales concernant le protocole et les questions soulevées pendant le processus de mise au point des lignes directrices étaient du ressort du Comité directeur.
Sponsors
Les fonds nécessaires à ce guide de recommandations sont fournis par Santé Canada et une subvention des Instituts de recherche en santé du Canada.
Contact
Jason Busse
Abstract
Language
fr
PICOS
PICO 40.0
Population
Patients with chronic non-cancer pain considering first line therapy for pain
Intervention
Trial of opioids.
Comparator
Optimization of therapy with NSAIDs.
Outcomes
PICO 40.0
Population
Patients with chronic noncancer pain beginning opioid therapy
Intervention
Limit opioid dose to a particular maximum dose
Comparator
No maximum opioid dose
Outcomes
PICO 40.0
Population
Patients with chronic noncancer pain with an active psychiatric disorder whose non-opioid therapy has been optimized, and who still experience persistent problematic pain
Intervention
Trial of opioids
Comparator
Continue established therapy without opioids
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain with a history of substance use disorder, whose non-opioid therapy has been optimized, who still experience persistent problematic pain
Intervention
Trial of opioids
Comparator
Continuing established therapy without opioids
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain with an active substance use disorder whose non-opioid therapy has been optimized
Intervention
Trial of opioids
Comparator
Continue established therapy without opioids
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain considering first line therapy for pain
Intervention
Trial of opioids.
Comparator
Optimization of therapy with tricyclic antidepressants.
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain considering first line therapy for pain
Intervention
Trial of opioids.
Comparator
Optimization of therapy with nabilone.
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain considering first line therapy for pain
Intervention
Trial of opioids.
Comparator
Optimization of therapy with mexiletine.
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain considering first line therapy for pain
Intervention
Trial of opioids.
Comparator
Optimization of therapy with anticonvulsants.
Outcomes
PICO 40.0
Population
Patients with chronic non-cancer pain, without current or past substance use disorder and without other current serious psychiatric disorders, whose therapy is optimized with non-opioids with persistent problematic pain
Intervention
Trial of opioids.
Comparator
Continue established therapy without opioids.
Outcomes
PICO 50.0
Population
Patients who want to taper opioids who are above the threshold dose
Intervention
Multidisciplinary Program
Comparator
No Multidisciplinary Program
Outcomes
PICO 50.0
Population
Patients with chronic non-cancer pain on opioids with persistent problematic pain
Intervention
Tapering of opioid
Comparator
Keeping the dose of opioid the same
Outcomes
PICO 50.0
Population
Patients with chronic non-cancer pain with persistent problematic pain and/or problematic side effects
Intervention
Rotation to other opioids
Comparator
No change in opioid therapy
Outcomes
PICO 70.0
Population
Patients with chronic non-cancer pain on long-term opioid therapy with clinical and biochemical evidence of hypogonadism.
Intervention
Hormone replacement therapy while maintaining current opioid dose.
Comparator
Taper opioids to treat hypogonadism.
Outcomes
PICO 70.0
Population
Patients with chronic non-cancer pain prior to starting long term opioid therapy
Intervention
Urine drug screening for baseline substance use.
Comparator
No urine drug screening for baseline substance use.
Outcomes
PICO 70.0
Population
Patients with chronic non-cancer pain prior to starting long-term opioid therapy
Intervention
Formal structured treatment agreements.
Comparator
No formal structured treatment agreement.
Outcomes
PICO 70.0
Population
Patients with chronic non-cancer pain prior to starting long-term opioid therapy.
Intervention
Provide take-home naloxone along with opioid prescription.
Comparator
Do not provide take-home naloxone along with opioid prescription.
Outcomes
PICO 70.0
Population
Patients with chronic non-cancer pain prior to starting long-term opioid therapy
Intervention
Controlled release opioids
Comparator
Immediate release opioids
Outcomes
