The Role of the Multidisciplinary Team for Opioid Stewardship: A Scoping Review.

Background: The global opioid crisis has prompted healthcare systems to implement opioid stewardship programs (OSPs) aimed at optimizing prescribing practices and mitigating harm. Multidisciplinary teams (MDTs) are increasingly recognized as central to the success of these programs, yet their roles, structures, and implementation across clinical contexts remain poorly defined. Objective: This scoping review explores the composition, functions, and contextual application of MDTs within OSPs. It aims to map the professional roles, describe the interventions deployed, examine reported outcomes, and identify implementation barriers and facilitators across healthcare settings. Methods: Following the Joanna Briggs Institute framework and PRISMA-ScR guidelines, a systematic search of PubMed was conducted to identify studies involving MDT-led opioid stewardship interventions. Studies were eligible if they described multidisciplinary collaboration in opioid prescribing, pain management, or harm-reduction efforts. Data were extracted on team composition, interventions, outcomes, and contextual factors, and synthesized narratively. Results: Thirteen studies published between 2017 and 2023 were included. Most were U.S.-based and employed descriptive or observational designs across varied settings, including hospitals, primary care, rural clinics, and telemedicine platforms. Core MDT members included physicians, pharmacists, and nurses, with frequent contributions from addiction specialists, psychologists, and social workers. Common interventions included opioid-sparing protocols, individualized tapering plans, naloxone co-prescribing, and interprofessional education. Reported outcomes included reductions in opioid prescribing, improved adherence to safety protocols, and enhanced provider confidence. Implementation challenges included limited staffing, fragmented communication, and patient resistance, while facilitators included standardized workflows, institutional support, and integrated electronic health systems. Conclusion: MDTs play a critical role in operationalizing opioid stewardship across diverse clinical environments. Their effectiveness depends not only on professional composition but also on systemic support for collaboration, training, and workflow integration. Future research should evaluate the comparative impact of MDT configurations using standardized outcome measures and expand to non-US and resource-limited settings.