International comparison of mitigation strategies for addressing opioid misuse: A systematic review

Uba, Richie Onwuchekwa; Ankoma-Darko, Kofi; Park, Sharon K.

doi:10.1016/j.japh.2019.09.002

Cited by 11 publications

(9 citation statements)

References 13 publications

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“…Furthermore, with patient data obtained from a US hospital, the generalizability of our findings to non-US settings is uncertain. Internationally, clinical documentation practices related to OUD may diverge, given differences across countries in opioid availability and use, opioid prescribing privileges, medication regulations, overdose management, OUD diagnostic criteria, reporting or recognition of OUD, treatment availability, stigma, and cultural factors ( 32 , 33 ). Additionally, most of the study individuals had only one discharge summary and medical history was sometimes limited if a patient had no prior record within the MIMIC-III dataset.…”

Section: Discussionmentioning

confidence: 99%

Classifying Characteristics of Opioid Use Disorder From Hospital Discharge Summaries Using Natural Language Processing

Poulsen

Freda

Troiani

et al. 2022

Front. Public Health

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BackgroundOpioid use disorder (OUD) is underdiagnosed in health system settings, limiting research on OUD using electronic health records (EHRs). Medical encounter notes can enrich structured EHR data with documented signs and symptoms of OUD and social risks and behaviors. To capture this information at scale, natural language processing (NLP) tools must be developed and evaluated. We developed and applied an annotation schema to deeply characterize OUD and related clinical, behavioral, and environmental factors, and automated the annotation schema using machine learning and deep learning-based approaches.MethodsUsing the MIMIC-III Critical Care Database, we queried hospital discharge summaries of patients with International Classification of Diseases (ICD-9) OUD diagnostic codes. We developed an annotation schema to characterize problematic opioid use, identify individuals with potential OUD, and provide psychosocial context. Two annotators reviewed discharge summaries from 100 patients. We randomly sampled patients with their associated annotated sentences and divided them into training (66 patients; 2,127 annotated sentences) and testing (29 patients; 1,149 annotated sentences) sets. We used the training set to generate features, employing three NLP algorithms/knowledge sources. We trained and tested prediction models for classification with a traditional machine learner (logistic regression) and deep learning approach (Autogluon based on ELECTRA's replaced token detection model). We applied a five-fold cross-validation approach to reduce bias in performance estimates.ResultsThe resulting annotation schema contained 32 classes. We achieved moderate inter-annotator agreement, with F1-scores across all classes increasing from 48 to 66%. Five classes had a sufficient number of annotations for automation; of these, we observed consistently high performance (F1-scores) across training and testing sets for drug screening (training: 91–96; testing: 91–94) and opioid type (training: 86–96; testing: 86–99). Performance dropped from training and to testing sets for other drug use (training: 52–65; testing: 40–48), pain management (training: 72–78; testing: 61–78) and psychiatric (training: 73–80; testing: 72). Autogluon achieved the highest performance.ConclusionThis pilot study demonstrated that rich information regarding problematic opioid use can be manually identified by annotators. However, more training samples and features would improve our ability to reliably identify less common classes from clinical text, including text from outpatient settings.

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Section: Discussionmentioning

confidence: 99%

Classifying Characteristics of Opioid Use Disorder From Hospital Discharge Summaries Using Natural Language Processing

Poulsen

Freda

Troiani

et al. 2022

Front. Public Health

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“…While opioid abuse has become a social problem in the United States, opioids are still underused in Japan. 23 The obstacle to education on effective opioid prescriptions seems to be a strong belief that opioids are taboo for respiratory disease patients because of their suppression of respiratory function. 24 Academic societies related to palliative and home care must inform patients that there are patients who benefit from opioid prescriptions and promote the proper use of opioids.…”

Section: Discrepancy In the Implementation Of Effective Palliative Ca...mentioning

confidence: 99%

Palliative home care for older patients with respiratory disease in Japan: Practices and opinions of physicians

Yamanaka

Kidana

Yamaguchi

et al. 2022

Geriatrics Gerontology Int

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Aim: Older adults at the end-of-life stage receiving home visits from physicians often experience symptoms such as dyspnea, pain and fatigue, among others. This study aimed to investigate the practices and opinions of physicians providing home visits regarding palliative care for older adults with respiratory symptoms due to non-malignant diseases in Japan.Methods: A nationwide questionnaire survey on home palliative care for non-cancer chronic respiratory diseases was sent to 2988 home-care physicians in 2020 through postal mail and/or email. The questions focused on their background, their use of rating scales to evaluate the intensity of dyspnea, and their practices and opinions regarding home palliative care for respiratory diseases or symptoms.Results: Valid responses were collected from 592 physicians (19.8%). A total of 251 participants (43.1%) used a rating scale to evaluate the intensity of dyspnea. While 87.8%, 86.6%, 67.3%, and 60.0% of physicians considered pulmonary rehabilitation, morphine, sedative medications, and non-invasive positive pressure ventilation (NPPV), respectively, as effective in relieving respiratory distress, 73.0%, 66.9%, 57.3%, and 55.2% of those physicians, respectively, used each modality to relieve respiratory distress. Frequently involved physicians in the aforementioned care prescribed morphine or sedative medications and used NPPV more frequently.Conclusions: This study found a discrepancy between the proportion of physicians who considered palliative care as effective and those who prescribed it. Geriatr Gerontol Int 2022; 22: 943-949.

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“…While it shows that the United States has higher usage per capita, it also explains the steps taken by governmental bodies to control the crises. The steps include targeting the number of opioids per patient, limiting the type of clinicians allowed to prescribe opioids, and increasing opioid substitution treatment programs [12].…”

Section: Short Communicationmentioning

confidence: 99%

How Dental Professional Are Combating Opioid Addiction

Krajekian¹

2020

ADOH

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International comparison of mitigation strategies for addressing opioid misuse: A systematic review

Cited by 11 publications

References 13 publications

Classifying Characteristics of Opioid Use Disorder From Hospital Discharge Summaries Using Natural Language Processing

Classifying Characteristics of Opioid Use Disorder From Hospital Discharge Summaries Using Natural Language Processing

Palliative home care for older patients with respiratory disease in Japan: Practices and opinions of physicians

How Dental Professional Are Combating Opioid Addiction

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