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Review
. 2025 Jun 18;10(4):e1284.
doi: 10.1097/PR9.0000000000001284. eCollection 2025 Aug.

Quality indicators for opioid stewardship interventions in hospital inpatient and emergency departments: a systematic review

Chelsea Dutkiewicz  1 , Katelyn Jauregui  1   2 , Shania Liu  1 , Racha Dabliz  1 , Asad E Patanwala  1   3 , Jonathan Penm  1   4
Affiliations
Review

Quality indicators for opioid stewardship interventions in hospital inpatient and emergency departments: a systematic review

Chelsea Dutkiewicz et al. Pain Rep. .

Abstract

A systematic review was conducted to identify existing quality indicators for opioid stewardship in hospital inpatient and emergency departments. Five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Scopus) and grey literature were searched up to April 2022 to identify articles containing quality indicators for opioid stewardship in the hospital setting. Quality indicators were classified into (1) structure, (2) process, and (3) outcome according to Donabedian model and further analysed as subgroups. Risk of bias assessment was performed by 2 independent reviewers. In total, 4621 articles were identified after duplicates were removed, of which 20 full-text articles were screened for eligibility and 8 articles included in the review. There were 81 quality indicators extracted, of which 49 were unique quality indicators. Analysis produced 25% (12/49) structure, 61% (30/49) process, and 14% (7/49) outcome quality indicators. These quality indicators may be used to developed future quality standards, although further study is needed to improve patient data collection for outcome quality indicators to allow for more holistic evaluation of opioid stewardship programs.

Keywords: Emergency department; Hospitals; Inpatient; Opioid; Pain management; Prescribing.

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Conflict of interest statement

The authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart of the literature search.
See this image and copyright information in PMC

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References

    1. Al-Samawy S, Varughese N, Vaillancourt R, Wang XY, Penm J. A global survey on opioid stewardship practices in hospitals: a cross-sectional pilot study. Pharmacy 2021;9:122. - PMC - PubMed
    1. Alexandridis AA, McCort A, Ringwalt CL, Sachdeva N, Sanford C, Marshall SW, Mack K, Dasgupta N. A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina. Inj Prev 2018;24:48–54. - PMC - PubMed
    1. Allen M, Sproule B, MacDougall P, Furlan A, Murphy L, Borg Debono V, Buckley N. Identifying appropriate outcomes to help evaluate the impact of the Canadian guideline for safe and effective use of opioids for non-cancer pain. BMC Anesthesiol 2020;20:6–9. - PMC - PubMed
    1. Awadalla R, Gnjidic D, Patanwala A, Sakiris M, Penm J. The effectiveness of stewardship interventions to reduce the prescribing of extended-release opioids for acute pain: a systematic review. Pain Med 2020;21:2401–11. - PubMed
    1. Black N, Jenkinson C. Measuring patients' experiences and outcomes. BMJ 2009;339:b2495. - PubMed

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