Peer Review Report For: Associations between pharmaceutical industry interactions and prescribing practices in chronic non-malignant pain management: A protocol for a systematic review [version 2; peer review: 1 approved, 1 not approved]

Abstract

Introduction Chronic non-malignant pain (CNMP) represents a major global health issue and is a primary reason for disability worldwide. Managing CNMP often involves prescribing analgesics which carry risks such as dependency and adverse outcomes. Interactions between healthcare professionals (HCPs) and the pharmaceutical industry, including financial incentives, gifts, and sponsored education, may influence analgesic prescribing practices. Understanding these dynamics is essential for promoting ethical, evidence-based prescribing and ensuring patient safety. Therefore, the aim is to assess how pharmaceutical industry interactions with HCPs affect the prescribing of analgesics, specifically in the context of CNMP management. Methods This is a protocol for a systematic review, which is also prospectively registered on PROSPERO (Registration Number: CRD42024627184) and is reported according to PRISMA-P guidelines. A systematic search will be performed across MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science. Observational studies (e.g., cross-sectional, cohort) evaluating the association between pharmaceutical industry interactions and HCPs’ prescribing patterns for CNMP management will be included. Primary outcomes include analgesic prescribing patterns, such as rate, volume, and cost. Secondary outcomes involve patient safety measures and HCP attitudes towards prescribing. Titles, abstracts, and full texts will be screened according to the inclusion criteria. Data extraction will utilize a standardized form, and the methodological quality will be evaluated using the ROBINS-I tool. Screening, data extraction and quality appraisal will be conducted by two reviewers, independently, resolving any discrepancies with the help of a third reviewer. Should there be sufficient homogeneity in the results data, a meta-analysis will be conducted; if not, the findings will be presented in a narrative synthesis. The strength of evidence will be assessed using the GRADE approach. Discussion The findings could inform strategies to enhance unbiased and evidence-based prescribing in CNMP management, promoting better patient care.