Opioid prescribing practices in the U.S. and subsequent falls: a scoping review protocol

BACKGROUND: Falls resulting from or related to opioid use are a major concern for morbidity and mortality in the United States. The Centers for Disease Control and Prevention's Clinical Practice Guideline for Prescribing Opioids for Pain - United States 2022 seeks to enhance the effectiveness and safety of pain treatment by improving function and quality of life for patients with pain while reducing opioid-related risks. The American College of Surgeons' Best Practices Guidelines in Geriatric Trauma Management and the 4 M's Framework of an Age-Friendly Health System both recommend incorporating fall prevention and safe mobility strategies into healthcare for older adults. In line with these guidelines and our review questions, this scoping review protocol aims to better understand the research on opioid prescribing practices and subsequent falls by identifying and mapping (1) the types of available evidence about opioid prescribing practices and subsequent falls and (2) the key characteristics of treatment and continuing care of falls with specific emphasis on opioid prescribing practices. METHODS: Electronic database searches will be conducted in PubMed, Embase, CINAHL, and Scopus to identify evidence published in the United States from January 1, 2016, onward. This scoping review will consider primary literature, observational, quasi-experimental, and experimental, implementation, and quality improvement studies, as well as systematic reviews and meta-analyses. Eligible studies will focus on adults aged 18 years and older who have been prescribed opioids and subsequently experienced a fall. DISCUSSION: There is a gap in our understanding about opioid prescribing and subsequent falls. This scoping review will help fill this gap by mapping the recent available evidence-aligned with clinical guidelines about (1) prescribing practices and subsequent falls and (2) key characteristics of the treatment and continuing care of falls. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework ID: https://doi.org/10.17605/OSF.IO/JP49Y. https://osf.io/jp49y.