A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT.
A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT.
复制标题
风险教育计划减少剩余处方阿片类药物保留：随机对照试验。
DOI：
10.1016/j.amepre.2022.04.035
复制
发表时间：
2022
影响因子：
5.5
通讯作者：
Zikmund-Fisher,BrianJ
中科院分区：
文献类型：
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作者：
Voepel-Lewis,Terri;Boyd,CarolJ;Tait,AlanR;McCabe,SeanEsteban;Zikmund-Fisher,BrianJ
简介保留剩余的处方阿片类药物会给青少年和其他家庭成员带来转移、滥用、过量和死亡的风险。本研究探讨了新的教育计划是否会增强家长的风险认知和处置意愿，并减少他们保留剩余的处方阿片类药物。研究设计本研究是一项随机对照试验 (NCT03287622)。设置/参与者2017 年至 2019 年间从中西部一家学术儿科医院招募了总共 648 名其孩子服用阿片类镇痛药的家长。家长被随机接受常规信息（对照）或干预措施使用交互式决策反馈提供阿片类药物风险和缓解建议。主要结果指标主要结果指标是父母对保留/共享阿片类药物风险的看法以及在基线、第 3 天和第 14 天测量的儿童滥用情况、他们处置剩余阿片类药物的意图以及孩子使用后（当天或前后）的最终保留决定14).结果仅干预组的父母在第 14 天期间感知到的儿童滥用和保留/共享阿片类药物的风险较基线有所增加 (p≤0.006)。然而，各组之间的风险认知没有显着差异，并且在两次随访中对处置意图都没有干预效果。尽管有这些发现，但在针对重要的父母和孩子协变量进行调整后，干预措施降低了父母保留阿片类药物的可能性（AOR=0.48；95% CI=0.25、0.93；p=0.028）。报告过去滥用阿片类药物的父母也表现出较高的保留行为（AOR=4.78；95% CI=2.05, 11.10；p<0.001）。 结论 针对特定场景的教育干预强调剩余阿片类药物对儿童造成的潜在风险，并提供风险缓解建议，减少了父母对孩子剩余阿片类药物的保留。从有孩子的家庭中清除剩余的处方药可能是减少青少年转移、意外中毒和滥用的重要一步。试验注册本研究已在 www.clinicaltrials.gov NCT03287622 上注册。
IntroductionRetaining leftover prescription opioids poses the risks of diversion, misuse, overdose, and death for youth and other family members. This study examined whether a new educational program would enhance risk perceptions and disposal intentions among parents and decrease their retention of leftover prescription opioids.Study DesignThis study is an RCT (NCT03287622).Setting/ParticipantsA total of 648 parents whose children were prescribed opioid analgesics were recruited from a Midwestern, academic pediatric hospital between 2017 and 2019. Parents were randomized to receive routine information (control) with or without Scenario-Tailored Opioid Messaging Program intervention.InterventionThe intervention provided opioid risk and mitigation advice using interactive decisional feedback.Main Outcome MeasuresThe main outcome measures were parents’ perceptions of the riskiness of keeping/sharing opioids and child misuse measured at baseline, Days 3 and 14, their intention to dispose of leftover opioids, and their final retention decisions after the child's use (at or around Day 14).ResultsPerceived riskiness of child misuse and keeping/sharing opioids increased from baseline through Day 14 only for parents in the intervention group (p≤0.006). However, there were no significant differences in risk perceptions between groups and no intervention effect on disposal intentions at either follow-up. Despite these findings, the intervention reduced the likelihood of parents’ opioid retention when adjusted for important parent and child covariates (AOR=0.48; 95% CI=0.25, 0.93;p=0.028). Parents who reported past opioid misuse also showed higher retention behavior (AOR=4.78; 95% CI=2.05, 11.10;p<0.001).ConclusionsA scenario-specific educational intervention emphasizing the potential risks that leftover opioids pose to children and that provided risk mitigation advice decreased parents’ retention of their child's leftover opioid medication. Removing leftover prescription drugs from homes with children may be an important step to reducing diversion, accidental poisoning, and misuse among youth.Trial RegistrationThis study is registered at www.clinicaltrials.gov NCT03287622.