Clinical decision support systems for opioid prescribing for chronic non-cancer pain in primary care: a scoping review

Sheryl Spithoff, Stephanie Mathieson, Frank Sullivan, Qi Guan, Abhimanyu Sud, Susan Hum, Mary Ann O'Brien

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background and Objectives: Clinical decision support systems (CDSSs) may help clinicians prescribe opioids for chronic noncancer pain (CNCP) more appropriately. This scoping review determined the extent and range of the current evidence on CDSSs for opioid prescribing for CNCP in primary care, and whether investigators followed best evidence and current guidance in designing, implementing and evaluating these complex interventions.

Methods: We searched 9 electronic databases and other data sources for studies from January 1, 2008 to October 11, 2019. Two reviewers independently screened the citations. One reviewer extracted data and a second verified for accuracy. INCLUSION CRITERIA: study of a CDSS for opioid prescribing for CNCP in a primary care clinical setting. We reported quantitative results in tables and qualitative results in narrative form.

Results: Our search yielded 5068 records, of which 14 studies met our inclusion criteria. All studies were conducted in the United States. Six studies examined local (eg, health center) CDSSs and 8 examined prescription drug monitoring program CDSSs. Three CDSSs incorporated evidence-based components. Study aims were heterogeneous and study designs included both quantitative and qualitative methodologies. No studies assessed patient health outcomes. Few studies appeared to be following guidance for evaluating complex interventions. 

Conclusions: Few studies have rigorously assessed the use of CDSSs for opioid prescribing for CNCP in primary care settings. Going forward, investigators should include evidence-based components into the design of CDSSs and follow guidance for the development and evaluation of complex interventions.

Original languageEnglish
Pages (from-to)529-540
Number of pages12
JournalJournal of the American Board of Family Medicine
Issue number4
Early online date16 Jul 2020
Publication statusPublished - Jul 2020


  • Biomedical technology assessment
  • Chronic pain
  • Clinical decision support systems
  • Clinical decision-making
  • Electronic health records
  • Information technology
  • Opioid-related disorders
  • Outcomes assessment
  • Prescription drug monitoring programs
  • Translational medical research


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