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Primary care intervention to reduce prescription opioid overdoses

初级保健干预减少处方阿片类药物过量

基本信息

批准号：
9145508
负责人：
Amy S B Bohnert
金额：
--
依托单位：
VETERANS HEALTH ADMINISTRATION
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2019-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9145508
关键词：
Address Address Adverse event Adverse event Afghanistan Afghanistan Alcohol consumption Alcohol consumption Alcohol or Other Drugs use Alcohol or Other Drugs use Analgesics Attention Attention Behavior Behavior Behavior Therapy Behavior Therapy Behavioral Behavioral Caring Caring Cessation of life Cessation of life Clinic Clinic Cognitive Cognitive Complement Complement Conflict (Psychology)Conflict (Psychology)Controlled Study Controlled Study Data Data Dose Dose Elements Elements Emergency department visit Emergency department visit Ensure Ensure Future Future General Population Health Personnel Health Personnel Healthcare Systems Healthcare Systems Injury Injury Intervention Intervention Iraq Iraq Knowledge Knowledge Location Location Measures Measures Mediator of activation protein Mediator of activation protein Mental Health Mental Health Modality Modality Morphine Motivation Motivation Opioid Opioid Opioid Analgesics Outcome Outcome Overdose Overdose Pain Pain Pain management Pain management Pain quality Pain quality Participant Participant Patient Care Patient Self-Report Patient Self-Report Patients Patients Personal Satisfaction Personal Satisfaction Pharmaceutical Preparations Pharmaceutical Preparations Pharmacy facility Pharmacy facility Prescription opioid overdose Preventive Intervention Preventive Intervention Primary Health Care Primary Health Care Provider Provider Public Health Public Health Randomized Randomized Randomized Controlled Trials Randomized Controlled Trials Records Records Recruitment Activity Reporting Reporting Risk Risk Risk Behaviors Risk Behaviors Risk Reduction Risk Reduction Safety Safety Sedation procedure Sedation procedure Self Efficacy Self Efficacy Services Services United States United States Veterans Veterans Violence Violent injury adverse outcome adverse outcome behavior change behavior change behavioral health behavioral health brief intervention brief intervention care providers chronic pain chronic pain coping coping evidence base evidence base follow-up follow-up health administration health administration improved improved intervention effect intervention effect morphine equivalent opioid mortality opioid overdose opioid therapy opioid use opioid use overdose death overdose prevention overdose prevention overdose risk pill pill pragmatic trial pragmatic trial prescription opioid prescription opioid prevent prevent recruit therapy design therapy design treatment as usual treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Reducing opioid pain medication-related adverse outcomes among patients prescribed opioids for pain is critical for ensuring safe and high quality pain care in the Veterans Health Administration (VHA). Overdose is one such adverse outcome; overdose has substantially increased over the past decade and is a highly significant concern for Veterans, VHA care providers, and other stakeholders. A number of VHA initiatives have sought to improve prescribing practices in an effort to address this problem. Concurrent strategies that reduce patient behaviors that increase overdose risk have the potential to complement these efforts, but have not been examined in a controlled study. Primary care is an ideal location for identifying patients prescribed opioids who are at risk for adverse outcomes. Recent initiatives, such as Primary Care Mental Health (PC-MH), have led to the integration of behavioral health providers into primary care and provide the opportunity to deliver behavioral interventions designed specifically to reduce risky opioid use. The purpose of the Prescription Opioid Safety Trial (POST) study is to conduct a randomized controlled trial of a brief intervention to reduce opioid overdose risk behaviors among VHA primary care patients receiving long-term opioid therapy. The intervention blends elements of motivational enhancement interventions for risky substance use and cognitive behavioral pain management interventions. This new intervention will be compared to an equal attention enhanced usual care condition, with both conditions delivered by PC-MH therapists. The study will recruit 450 patients with long-term opioid use who are currently prescribed opioid doses of 50 morphine-equivalent mg/day or greater (an indicator of elevated overdose risk) from primary care clinics at the VA Ann Arbor Healthcare System. The specific aims are: Aim 1) to examine if patients randomly assigned to a brief overdose prevention intervention report reduce