Managing opioid use disorder in primary care: PEER simplified guideline

Christina Korownyk, Danielle Perry, Joey Ton, Michael R Kolber, Scott Garrison, Betsy Thomas, G Michael Allan, Cheryl Bateman, Raquel de Queiroz, Dorcas Kennedy, Wiplove Lamba, Jazmin Marlinga, Tally Mogus, Tony Nickonchuk, Eli Orrantia, Kim Reich, Nick Wong, Nicolas Dugré, Adrienne J Lindblad
Canadian Family Physician Médecin de Famille Canadien 2019, 65 (5): 321-330

OBJECTIVE: To use the best available evidence and principles of shared, informed decision making to develop a clinical practice guideline for a simplified approach to managing opioid use disorder (OUD) in primary care.

METHODS: Eleven health care and allied health professionals representing various practice settings, professions, and locations created a list of key questions relevant to the management of OUD in primary care. These questions related to the treatment setting, diagnosis, treatment, and management of comorbidities in OUD. The questions were researched by a team with expertise in evidence evaluation using a series of systematic reviews of randomized controlled trials. The Guideline Committee used the systematic reviews to create recommendations.

RECOMMENDATIONS: Recommendations outline the role of primary care in treating patients with OUD, as well as pharmacologic and psychotherapy treatments and various prescribing practices (eg, urine drug testing and contracts). Specific recommendations could not be made for management of comorbidities in patients with OUD owing to limited evidence.

CONCLUSION: The recommendations will help simplify the complex management of patients with OUD in primary care. They will aid clinicians and patients in making informed decisions regarding their care.

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