Addressing the prescription opioid crisis from the provider side- optimizing research and intervention design for maximum impact on public health

摘要 骨科医生是第三大阿片类药物处方组。学术出版物 肌肉骨骼疾病和损伤领域已被淹没的手稿概述地方和分专业 集中努力减少这些药物的使用，并查明有长期滥用风险的病人。 这些干预措施通常是禁止性的，只与开发的地点有关，缺乏 适当的实验设计和不可扩展性。同样，提交的大型数据集分析， 阿片类药物的使用并不是最佳设计，以确定有慢性阿片类药物滥用风险的患者的特征。我们 计划在类阿片管理领域召集一批积极的调查人员，包括代表 从肌肉骨骼医学和外科的主要科学出版物的编辑人员中， 最佳研究设计，以解决优化阿片类药物处方模式的问题， 患者，并开发分析方法，以应用于大型管理数据集，以识别风险个体 长期虐待这次为期一天的会议的目标符合NIAMS指导的RFA机制， 疼痛研究中的模型、测量和管理（PA 18-159，18-141）以及NIH HEAL 这两项倡议都涉及其他NIH机构。在会议结束时，可交付的成果将是： 最佳的研究设计，跨专科和肌肉骨骼条件的问题 并且可以在大型医疗保健系统中扩展，以及（ii）大型数据集的分析方法 识别高危患者会议讨论会将发表在《骨与关节外科杂志》上 与NIAMS共享。

ABSTRACT Orthopaedic surgeons are the 3rd largest physician opioid prescribing group. Scholarly publications in the musculoskeletal disease and injury field have been inundated with manuscripts outlining local and subspecialty focused attempts to decrease the use of these medications and to identify patients at risk of chronic abuse. The interventions are generally are proscriptive, relative only to the site where it was developed, lacking in appropriate experimental design and un-scalable. Similarly, submitted analyses of large data sets examining opioid use are not optimally designed to identify characteristics of patients at risk for chronic opioid abuse. We plan to assemble a group of active investigators in the area of opioid management, including representatives from the editorial staffs of the major scientific publications in musculoskeletal medicine and surgery, to identify optimum research designs to address the issues of optimizing opioid prescribing patterns for low and high-risk patients and develop analytic approaches to apply to large administrative data sets to identify individuals at risk for chronic abuse. The goals of this one-day meeting are in line with NIAMS directed RFA’s Mechanisms, Models, Measurement and Management in Pain Research (PA 18-159, 18-141) as well as the NIH HEAL initiative both of which involve other NIH agencies. At the end of the meeting, the deliverables will be (i) optimum research designs which approach the issue across subspecialties and musculoskeletal conditions and which can be scalable across large health care systems, and (ii) analytic approaches for large data sets which identify at-risk patients. The meeting symposia will be published in a Journal of Bone and Joint Surgery supplement and shared with NIAMS.