Scenario-tailored opioid messaging program: An interactive intervention to prevent analgesic-related adverse drugs events in children and adolescents

情景定制的阿片类药物信息传递计划：预防儿童和青少年镇痛相关药物不良事件的互动干预

• 批准号: 9470101
• 负责人: Terri Diane Voepel-Lewis
• 金额: $ 50.57万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9470101
• 关键词: Acute; Acute Pain; Address; Adjuvant Analgesic; Admission activity; Adolescent; Adolescent Behavior; Adolescent and Young Adult; Adult; Adverse drug event; Adverse effects; Analgesics; Attention; Behavior; Belief; Child; Childhood; Coffee; Communication; Communities; Control Groups; Dangerousness; Data; Decision Making; Drug Addiction; Drug Storage; Ensure; Exercise; Exhibits; Family member; Feedback; Friends; Funding; Future; Goals; Home environment; Hospitals; Instruction; Intervention; Knowledge; Learning; Left; Life; Measures; Medicine; Methods; Morbidity - disease rate; Motivation; Opioid; Opioid Analgesics; Orthopedic Surgery procedures; Outcome; Pain; Pain interference; Pain management; Parents; Perception; Pharmaceutical Preparations; Poisoning; Policies; Postoperative Period; Provider; Public Health; Randomized; Randomized Clinical Trials; Recovery of Function; Research; Risk; Risk Reduction; Safety; Sedation procedure; Self Efficacy; Serious Adverse Event; Symptoms; Testing; Time; Toxic effect; Visit; Work; Youth; aged; clinical effect; clinically relevant; cost efficient; experience; improved; innovation; interactive multimedia; intervention program; misuse of prescription only drugs; mortality; multidisciplinary; novel strategies; opioid misuse; opioid use; overdose death; prescription opioid; prevent; programs; public health relevance; response; risk perception; routine provider; success; twelfth grade

Project Summary / Abstract The number of opioid prescriptions dispensed to U.S. youth more than doubled over a decade. Over the same period serious opioid-related adverse drug events (ADEs) soared to include thousands of hospital admissions and hundreds of accidental overdose deaths annually. Furthermore, recent estimates suggest that on an average day 2500 adolescents in the U.S. will misuse an opioid for the first time. The staggering number of ADEs and widespread misuse among youth reflects, in large part, a lack of knowledge about the potential dangers of opioids. We and others have previously shown that poor parental understanding leads to risky and potentially dangerous prescribed opioid-related decisions including giving the drug to a child with signs of toxicity, inadequate pain management, as well as inappropriate opioid storage and disposal behaviors. Thus, transforming the way in which providers give risk information at the time of opioid prescribing is critical to improve the safety of these potent analgesics in the homes of children and adolescents. The overarching goal of our research is to improve opioid analgesic safety and efficacy by optimizing opioid risk recognition, informed analgesic decision-making, and drug storage/disposal behaviors among parents of youth who are prescribed these agents for home use. With this proposal, we aim to demonstrate that our Scenario-Tailored Opioid Messaging Program (STOMP™) will: 1) Improve parents' opioid risk understanding and their analgesic decision-making; 2) Enhance parents' analgesic self-efficacy, analgesic use, storage behaviors and their children's pain outcomes, and 3) To demonstrate that the STOMP™ plus provision of a method to get rid of left-over medications will effectively nudge parents to safely dispose of left-over opioid analgesics. Parents whose children aged 5-17 years are prescribed opioids for acute, short-lived pain after ambulatory, orthopedic surgery will be randomly assigned to receive our interventions or a routine provider informational interaction at the time of opioid prescribing. We will follow parents for up to 30 days to assess their knowledge, risk perceptions, analgesic-decisions and use, the child's pain outcomes, and drug storage and disposal behaviors. These comprehensive data will allow us to compare the intervention and control groups to identify the most effective and efficient means to optimize parents' opioid-related risk reduction decisions and behaviors while enhancing their ability to manage their children's pain. Our innovative research will provide important data to inform providers on how to improve parents' opioid analgesic risk knowledge that will, in turn, promote safe and effective use of opioid analgesics in the homes of children and adolescents.

项目摘要/摘要 分发给美国年轻人的阿片类药物处方数量在十年内翻了一番多。在同样的情况下 期间与阿片类药物相关的严重不良反应事件(ADE)激增，包括数千人入院 每年有数百人死于意外服药过量。此外，最近的估计表明，在一个 美国平均每天有2500名青少年首次滥用阿片类药物。数量惊人的 ADS和年轻人中普遍存在的滥用在很大程度上反映了对这种潜力的缺乏了解 阿片类药物的危险。我们和其他人之前已经证明，父母不理解会导致危险和 潜在危险的处方阿片类药物相关决定，包括给有症状的儿童服用药物 毒性、疼痛管理不足，以及不适当的阿片类药物储存和处置行为。因此， 转变提供者在阿片类药物处方时提供风险信息的方式对于 提高这些强效止痛药在儿童和青少年家中的安全性。首要目标是 我们研究的重点是通过优化阿片类药物风险识别来提高阿片类止痛药的安全性和有效性， 青少年父母的知情止痛决策和药物储存/处置行为 把这些药剂开给家庭使用。通过这项提议，我们的目标是证明我们的场景-定制 阿片类药物信息计划(STOMP™)将：1)提高父母对阿片类药物风险的了解及其止痛药 2)提高父母的止痛自我效能感、止痛药的使用、存放行为及其对父母的影响 儿童的疼痛结局，以及3)演示STOMP™加提供了一种摆脱的方法 残留的药物将有效地推动父母安全地处置残留的阿片类止痛药。家长 其5-17岁的孩子被处方阿片类药物治疗门诊、骨科手术后的急性、短暂疼痛 手术将被随机分配以接受我们的干预或常规提供者信息交互，地址为 阿片类药物处方的时间。我们将跟踪父母长达30天，以评估他们的知识，风险 认知，止痛药的决定和使用，儿童的疼痛结果，以及药物储存和处置行为。 这些全面的数据将使我们能够比较干预组和控制组，以确定最 有效和高效的手段来优化父母的阿片类药物相关风险减少决策和行为，同时 增强他们管理孩子痛苦的能力。我们的创新研究将为 告知提供者如何提高父母对阿片类止痛药的风险知识，这反过来将促进安全和 在儿童和青少年家中有效使用阿片类镇痛剂。