Identifying patient-important outcomes in medication-assisted treatment for opioid use disorder patients: a systematic review protocol

Nitika Sanger; Hamnah Shahid; Brittany B Dennis; Jackie Hudson; David Marsh; Stephanie Sanger; Andrew Worster; Rand Teed; Launette Rieb; Peter Tugwell; Brian Hutton; Beverley Shea; Dorcas Beaton; Kimberly Corace; Danielle Rice; Lara Maxwell; M Constantine Samaan; Russell J de Souza; Lehana Thabane; Zainab Samaan

doi:10.1136/bmjopen-2018-025059

Identifying patient-important outcomes in medication-assisted treatment for opioid use disorder patients: a systematic review protocol

BMJ Open. 2018 Dec 4;8(12):e025059. doi: 10.1136/bmjopen-2018-025059.

Authors

Nitika Sanger^{1

2}, Hamnah Shahid^{2

3}, Brittany B Dennis^{4

5}, Jackie Hudson², David Marsh^{6

7}, Stephanie Sanger⁸, Andrew Worster^{5

9}, Rand Teed¹⁰, Launette Rieb¹¹, Peter Tugwell^{12

13

14

15}, Brian Hutton^{12

16}, Beverley Shea^{12

13

14}, Dorcas Beaton^{17

18}, Kimberly Corace^{19

20}, Danielle Rice¹², Lara Maxwell¹², M Constantine Samaan²¹, Russell J de Souza²², Lehana Thabane^{22

23}, Zainab Samaan^{2

22}

Affiliations

¹ Medical Science Gradaute Program, McMaster University, Hamilton, Ontario, Canada.
² Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
³ Arts and Sciences, McMaster University, Hamilton, Ontario, Canada.
⁴ St. George's Hospital Medical School, University of London, London, UK.
⁵ Department of Health Research Methods, Evaluation, and Impact, McMaster University, Hamilton, Ontario, Canada.
⁶ Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada.
⁷ Canadian Addiction Treatment Centres, McMaster University, Markham, Ontario, Canada.
⁸ Department of Health Sciences: Health Science Library, McMaster University, Hamilton, Ontario, Canada.
⁹ Department of Medicine, Hamilton General Hospital, Hamilton, Ontario, Canada.
¹⁰ Rand Teed Consulting Services, Craven, Saskatchewan, Canada.
¹¹ Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
¹² Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada.
¹³ Bruyère Research Institute, Ottawa, Ontario, Canada.
¹⁴ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁵ Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
¹⁶ School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ontario, Canada.
¹⁷ Institute for Work and Health, St. Michael's Hospital, Ottawa, Ontario, Canada.
¹⁸ Departments of Occupational Therapy and Medicine and the Clinical Epidemiology and Health Care Research Program, University of Toronto, Toronto, Ontario, Canada.
¹⁹ Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
²⁰ University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada.
²¹ Division of Pediatric Endocrinology, McMaster University, Hamilton, Ontario, Canada.
²² Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ontario, Canada.
²³ Centre for Evaluation of Medicines, Programs for Assessment of Technology in Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Abstract

Introduction: Illicit opioid use has become a national crisis in Canada, with over 65 000 people seeking treatment for opioid use disorder (OUD) in Ontario and British Columbia alone. Medication-assisted treatment (MAT) is a common treatment for OUD. There is substantial variability in treatment outcomes used to evaluate effectiveness of MAT, making it difficult to establish clinically and scientifically relevant treatment effect. Furthermore, patients are often excluded from the process of determining these outcomes. The primary objective of this review is to examine outcomes currently used to measure MAT effectiveness and to identify patient-relevant outcomes to enhance effectiveness of treatment options. This review refers to patient-important outcomes as those outcomes patients consider important to or markers of treatment success.

Methods and analysis: MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Library, Cochrane Clinical Trials Registry, National Institutes for Health Clinical Trials Registry and WHO International Clinical Trials Registry Platform databases will be searched. We will search databases from inception to the date the search is ran. Studies of interest include those evaluating the effectiveness of MAT for patients with OUD, with or without consultation with patients regarding what they consider to be important as an indicator of treatment success. Results will be analysed using thematic analysis and qualitative analysis where possible. This will result in comprehensive synthesis of all outcomes and measures found related to OUD treatment effectiveness.

Ethics and dissemination: We are collaborating with Canadian Addiction Treatment Centres which provide MAT to patients with OUD who will participate in disseminating study results. Dissemination strategies will involve sharing study results through workshops, presentations, peer-reviewed publications, study reports, community presentations and resources in primary care settings.

Prospero registration number: CRD42018095553.

Keywords: medication-assisted treatment; opioid use disorder; patient-centred; protocol; systematic review.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Analgesics, Opioid / adverse effects
Humans
Meta-Analysis as Topic
Opiate Substitution Treatment / methods
Opiate Substitution Treatment / standards*
Opioid-Related Disorders / drug therapy*
Patient Reported Outcome Measures
Sex Factors
Systematic Reviews as Topic
Treatment Outcome

Substances

Analgesics, Opioid

Abstract

Publication types

MeSH terms

Substances

Grants and funding