BACKGROUND The Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (COG) was developed in response to increasing rates of opioid-related hospital visits and deaths in Canada, and uncertain benefits of opioids for chronic non-cancer pain (CNCP). Following publication, we developed a list of evaluable outcomes to assess the impact of this guideline on practice and patient outcomes. METHODS A working group at the National Pain Centre at McMaster University used a modified Delphi process to construct a list of clinical and patient outcomes important in assessing the uptake and application of the COG. An advisory group then reviewed this list to determine the relevance and feasibility of each outcome, and identified potential data sources. This feedback was reviewed by the National Faculty for the Guideline, and a National Advisory Group that included the creators of the COG, resulting in the final list of 5 priority outcomes. RESULTS Five outcomes were judged clinically important and feasible to measure: 1) Effects of opioids for CNCP on quality of life, 2) Assessment of patient's risk of addiction before starting opioid therapy, 3) Monitoring patients on opioid therapy for aberrant drug-related behaviour, 4) Mortality rates associated with prescription opioid overdose and 5) Use of treatment agreements with patients before initiating opioid therapy for CNCP. Data sources for these outcomes included patient's medical charts, e-Opioid Manager, prescription monitoring programs and administrative databases. CONCLUSION Measuring the impact of best practice guidelines is infrequently done. Future research should consider capturing the five outcomes identified in this study to evaluate the impact of the COG in promoting evidence-based use of opioids for CNCP.

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确定适当的结果，以帮助评估《安全有效使用阿片类药物治疗非癌痛的加拿大指南》的影响。

背景技术针对在阿片类药物相关的医院就诊率和死亡人数增加以及阿片类药物对慢性非癌性疼痛的不确定性带来的益处，制定了《加拿大安全有效使用阿片类药物治疗慢性非癌性疼痛（COG）的加拿大指南》（ CNCP）。出版后，我们制定了可评估结果的清单，以评估该指南对实践和患者结果的影响。方法麦克马斯特大学国家疼痛中心的工作组使用改进的Delphi程序构建了一系列临床和患者预后，这些预后对评估COG的吸收和应用很重要。然后，一个咨询小组审查了该清单，以确定每个结果的相关性和可行性，并确定了潜在的数据来源。该反馈已由美国国家指南学院进行了审核，以及由COG的创建者组成的国家咨询小组，最终确定了5项优先结果。结果认为有五项结局在临床上具有重要意义并且可以衡量：1）CNCP的阿片类药物对生活质量的影响，2）开始使用阿片类药物之前评估患者的成瘾风险，3）监测患者使用阿片类药物治疗的药物相关异常行为，4）与处方阿片类药物过量相关的死亡率，以及5）在开始对CNCP进行阿片类药物治疗之前与患者使用治疗协议。这些结果的数据来源包括患者的病历，电子阿片类药物管理器，处方监测程序和管理数据库。结论很少测量最佳实践准则的影响。