Evaluation of a Mobile Application for Patients and Clinical Decision-making Support Tools for Prescribers to Decrease Opioid Misuse and Habit-forming Behaviors Following Post-operative Prescription

项目总结/摘要 阿片类药物滥用是一种流行病，也是一场公共卫生危机。至少有200万人使用阿片类药物 涉及处方阿片类药物的OUD，60万人患有海洛因OUD 6。令人担忧的是，80%的海洛因使用者 在过渡到海洛因之前使用处方阿片类药物7。因此，确保阿片类药物疼痛 以最小化异常药物相关行为的可能性的方式安全地施用治疗。 这需要个体化的阿片类药物治疗方案和严格的依从性，使有效的疼痛控制， 产生欣快感或戒断症状，两者都可能导致寻求药物的行为。连续精度 医学（CPM）旨在开发一个软件生态系统，以减少阿片类药物滥用和过度处方 术后患者。在自筹资金的第一阶段，我们开发了临床决策支持软件， 其由用于数据管理和分析的服务器和用于患者的移动的客户端应用程序组成。 数字平台提供个性化的时间表，记录剂量和疼痛水平，并激励 通过对依从性进行评分来确定给药依从性。在这个项目中，我们建议评估和改进CPM套件 临床决策支持工具，并为临床医生和患者提供可立即采取行动的信息， 减少术后期间阿片类药物的过度处方和滥用。在拟议的第二阶段 SBIR项目，CPM将完善和评估移动的应用程序，部署和测试处方者门户， 仪表板功能，使医生能够叠加药代动力学和药效学建模， 改善处方实践，阻止吸毒成瘾行为，并为501（k）准备材料 申请提交。CPM应用程序、患者数据和提供商门户网站，以最佳方式结合在一起 用于改善患者-提供者沟通和治疗计划，有可能预防 与过量处方和滥用阿片类药物（包括使用阿片类药物）相关的负面后遗症 紊乱过量和死亡

PROJECT SUMMARY/ABSTRACT Opioid misuse is an epidemic and a public health crisis. At least 2 million people have an opioid use disorder (OUD) involving prescription opioids, and 600,000 have heroin OUD6. Alarmingly, 80% of heroin users used prescription opioids before transitioning to heroin7. It is therefore critical to ensure that opioid pain therapies are administered safely, in a way that minimizes the potential for aberrant drug related behaviors. This necessitates individualized opioid regimens and strict adherence, enabling effective pain control without producing euphoria or withdrawals, both of which can lead to drug seeking behaviors. Continuous Precision Medicine (CPM) aims to develop a software ecosystem to reduce opioid misuse and over-prescription in postoperative patients. In a self-funded Phase I, we have developed clinical decision support software, which consists of a server for data management and analytics and a mobile client application for the patient. The digital platform delivers a personalized schedule, records dosing and pain levels, and motivates adherence to dosing by scoring compliance. In this project, we propose to evaluate and improve the CPM suite of clinical decision support tools and provide clinicians and patients with immediately actionable information to decrease over-prescription and misuse of opioids during the post-operative period. In the proposed Phase II SBIR project, CPM will refine and evaluate the mobile application, deploy and test a Prescriber Portal with dashboard functions to enable physicians to overlay pharmacokinetic and pharmacodynamic modeling to improve prescribing practices and deter drug-habit-forming behavior, and prepare materials for a 501(k) application submission. The CPM app, patient data, and provider portal, taken together and optimally employed to improve patient-provider communication and treatment planning, has the potential to prevent negative sequelae associated with over-prescription and misuse of opioids, including opioid use disorder, overdose, and death.