EHR Based Medication Complete Communication Strategy to Promote Safe Opioid Use

描述(由申请人提供)：本研究的总体目标是利用电子健康记录实施多方面的策略，以更好地教育急诊科患者有关阿片类止痛药的用药风险和安全使用。不安全服用阿片类药物不仅会导致副作用，还会导致呼吸抑制和死亡； 自20世纪90年代以来，与阿片类药物相关的过量死亡人数增加了两倍。每六名从急诊科出院的患者中就有一人收到阿片类药物的处方。不幸的是，最近的研究表明，急诊科出院流程不充分，患者往往在没有适当照顾自己所需知识的情况下离开。这种知识的缺乏对于接受阿片类药物的患者来说是潜在的危险，他们可能不知道如何安全地服用药物，也不知道它的潜在危险。该项目将利用多学科研究团队的优势，并结合几个健康素养适当的教育战略，以创建基于电子病历的药物完全沟通(EMC2)战略，以促进阿片类止痛药的安全使用。EMC2战略将在多个时间点使用多种模式向患者传递风险信息。我们将在一家城市学术急诊科进行一项三臂试验，以评估EMC2和EMC2+短信提醒策略与常规护理(N=816名患者；每个研究组272名患者)的比较。令人感兴趣的主要结果将是通过证明安全用药来衡量用药差错的减少。还将检查其他安全结果，并衡量患者的知识。此外，我们将评估干预措施的保真度和经济影响，以确定任何必要的修改，以指导未来的传播工作。

DESCRIPTION (provided by applicant): The overall objective of this study is to leverage the electronic health record to implement a multifaceted strategy to better educate emergency department patients about medication risks and safe use for opioid pain relievers. Failure to take opioids safely can result in not only side effects, but also respiratory depression and death; deaths from opioid-related overdoses have tripled since the 1990s. One of every six patients discharged from the emergency department (ED) receives a prescription for an opioid. Unfortunately, recent studies indicate that emergency department discharge processes are inadequate, and patients often leave without the knowledge necessary to properly care for themselves. This lack of knowledge is potentially dangerous for patients receiving opioids, who may not know how to take their medication safely or be aware of its potential hazards. This project will leverage the strengths of a multidisciplinary research team and combine several health-literacy appropriate educational strategies to create an EHR-based medication complete communication (EMC2) strategy to promote safe use of opioid pain relievers. The EMC2 strategy will impart risk information to patients at multiple points in time and using multiple modalities. We will conduct a three-arm trial at an urban academic emergency department to evaluate the EMC2 and EMC2+SMS text message reminder strategies compared to usual care (N=816 patients; 272 patients per study arm). The primary outcome of interest will be a decrease in medication errors as measured by demonstrated safe medication use. Other safety outcomes will also be examined and patient knowledge will be measured. Additionally, we will assess the fidelity and economic impact of the interventions to identify any necessary modifications to guide future dissemination efforts.