Draft Research Plan
Draft Research Plan for Prevention of Opioid Use Disorder: Interventions
This opportunity for public comment expired on January 16, 2019 at 8:00 PM EST
Note: This is a Draft Research Plan. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF. The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
This review will address patient- and clinician-level interventions to prevent opioid use disorder in persons not currently using opioids. In light of other evidence-based opioid prescribing guidelines (and their supporting systematic reviews), the USPSTF review will not include key questions (KQs) on the effectiveness and harms of interventions aimed at persons currently being prescribed opioids for pain management. Instead, interventions aimed at risk mitigation in persons taking opioids for pain management will be addressed in a contextual question.
Draft: Proposed Key Questions to Be Systematically Reviewed
- Do interventions to prevent opioid use disorder that are feasible for implementation in or referred from primary care improve patient health outcomes in persons not currently using opioids?
- Do interventions to prevent opioid use disorder that are feasible for implementation in or referred from primary care prevent the initiation of unnecessary opioid use, reduce the amount of opioid use, or prevent prescription misuse in persons not currently using opioids?
- What are the harms of interventions to prevent opioid use disorder that are feasible for implementation in or referred from primary care in persons not currently using opioids?
Draft: Proposed Contextual Questions
Contextual questions will not be systematically reviewed and are not shown in the Analytic Framework.
- What system- or practice-level interventions can help implement effective interventions to prevent opioid use disorder in primary care among persons not currently using opioids?
- What is the state of the evidence on interventions to prevent prescription misuse, opioid use disorder, or both in persons currently being prescribed opioids for pain management?
Draft: Proposed Research Approach
The Proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Report. Criteria are overarching as well as specific to each of the KQs.
|Condition||Any opioid use, including illicit opioid use, prescription opioid misuse, and opioid use disorder||Use of nonopioid drugs and other substances (alcohol, tobacco)|
|Aim||Prevention of prescription misuse and opioid use disorder in persons not currently using opioids through the avoidance or minimization of exposure to prescribed opioids and avoidance of nonmedical opioid use (defined as use of illicit opioids or nonmedical use of prescription opioids) altogether||
|Outcomes||KQ 1 (Health, social, and other outcomes):
Social and other outcomes:
KQ 2 (Patient behavioral outcomes):
KQ 3 (Harms):
|Outcome assessment timing||KQs 1, 2: At least 3 months after baseline measurement
KQ 3: No restrictions on timing of outcome measurement
|KQs 1, 2: Less than 3 months after baseline measurement|
|Study design||KQs 1, 2: Randomized, controlled trials; nonrandomized controlled trials; and prospective or retrospective cohort studies with concurrent selection of control cohorts
KQ 3: Trials, prospective or retrospective cohort studies, and case-control studies (for rare events)
|Time-series studies, pre-post studies, cross-sectional studies, case studies, case series
Note: If limited studies with included study designs, may consider ecologic studies or large cohort studies using historical control groups
|Country||Studies conducted in countries categorized as “Very High” on the United Nations Human Development Index (as defined by the United Nations Development Programme and based on 2015 indicators)||Studies conducted in countries not categorized as “Very High” on the 2015 Human Development Index|
|Publication language||English||Languages other than English|
|Study quality||Fair- or good-quality studies||Poor-quality studies (according to design-specific USPSTF criteria)|
Abbreviations: DSM=Diagnostic and Statistical Manual of Mental Disorders; HIV=human immunodeficiency virus; STI=sexually transmitted infection.
Internet Citation: Draft Research Plan: Prevention of Opioid Use Disorder: Interventions. U.S. Preventive Services Task Force. December 2018.