An augmented reality platform to reduce post-operative and chronic opioid use in pediatric cancer

增强现实平台可减少儿科癌症术后和长期阿片类药物的使用

基本信息

批准号：
10471451
负责人：
Juan Pablo Cata
金额：
$ 91.29万
依托单位：
ALTALITY, INC.
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10471451
关键词：
3-Dimensional Acute Adult Analgesics Augmented Reality Beds Cancer Center Cancer Patient Caregivers Cessation of life Child Childhood Chronic Clinical Clinical Trials Collaborations Collection Control Groups Critical Illness Critically ill children Data Data Analyses Dependence Device Approval Devices Diagnosis Disease Dose Effectiveness Family Feasibility Studies Feedback Future Goals Grant Helping to End Addiction Long-term Hospitalization Hospitals Human Resources Hyperalgesia Immunocompromised Host Inpatients Institutional Review Boards Intractable Pain Journals Legal patent Life Malignant Childhood Neoplasm Malignant Neoplasms Manuscripts Medical Device Medicine Movement Operative Surgical Procedures Opiate Addiction Opioid Outcome Outpatients Pain Pain management Patients Pediatric Hospitals Pediatric Oncologist Pediatric Oncology Pediatric cohort Peer Review Perioperative Persons Pharmaceutical Preparations Phase Phase II Clinical Trials Population Postoperative Pain Postoperative Period Procedures Protocols documentation Public Health Randomized Controlled Clinical Trials Randomized Controlled Trials Reporting Research Risk Sickle Cell Anemia Site Small Business Technology Transfer Research Source Specialist Substance abuse problem Surgical Oncology Surveys Survival Rate Survivors Texas Time Toxic effect Training Trauma United States National Institutes of Health academic review base childhood cancer survivor clinical pain cognitive modulation of pain college commercial application cost cost effective design disease transmission distraction efficacy evaluation experience feasibility testing handheld mobile device health care settings high risk high risk population long-term sequelae mobile application morphine equivalent non-opioid analgesic nonmedical use opioid abuse prevention opioid use pain reduction patient population pediatric patients phase 2 study prescription opioid prevent satisfaction tool usability virtual reality headset ward

项目摘要

PROJECT SUMMARY/ABSTRACT Pediatric opioid use is a public health crisis. In children, prescription opioids are the primary source of non- medical abuse as well as opioid-associated hospitalizations and deaths. Early opioid use in childhood is a known “gateway” to adulthood dependence and substance abuse disorders. Despite years of research, opioids remain the most commonly prescribed pain medication for children with cancer. These children experience pain from the time of diagnosis into adulthood as survivors, primarily from the treatment for their cancer. The majority of pediatric cancer patients have persistent opioid use in the months following major surgery to cure or to treat their disease. More concerning, studies in childhood cancer survivors show that major surgery increases risk of new-onset and chronic opioid use. The high costs and lack of scalability of traditional distraction-based medical devices for managing pain, such as virtual reality headsets, limit their clinical impact and commercial potential. As cancer patients are often immunocompromised, risk from infectious disease transmission from sharing devices is an additional, possibly life-threatening, concern. Mobile augmented reality applications eliminate these limitations, representing a cost-effective, safe and commercially viable adjunctive tool for pain management in critically ill children. Our goal is to reduce long-term opioid use in children with cancer undergoing major surgery by distracting them from their pain with a scavenger hunt-style mobile AR game while they are recovering in the hospital. To achieve this goal, we have collaborated with pediatric oncologists, anesthesiologists and pain specialists at the MD Anderson Cancer Center and the Baylor College of Medicine (Texas Children’s Hospital). In Phase I, we will demonstrate the feasibility of investigating the ARISE (Augmented Reality Incorporating Spatial Enhancement) game for reducing opioid consumption in the inpatient postoperative wards. In Phase II, we will evaluate the efficacy of the game to reduce immediate and long-term postoperative opioid use in children with cancer undergoing major treatment-related surgery in a multi-site randomized controlled clinical trial (AURORA trial: Augmented Reality for Opioid Reduction in Childhood Cancer). To our knowledge, this is the first RCT to investigate mobile augmented reality for opioid reduction in pediatric cancer patients or for postoperative opioid reduction in any pediatric population. As the majority of children with cancer are expected to survive long-term, the benefits of reducing and preventing chronic opioid use in this high-risk, refractory pain population will last over the lifetime of a child.

项目摘要/摘要小儿阿片类药物使用是一种公共卫生危机。在儿童中，处方阿片类药物是非 - 医学虐待以及阿片类药物相关的住院和死亡。童年早期使用阿片类药物是已知的“门户”对成年依赖性和药物滥用障碍。尽管研究了多年，阿片类药物仍然是癌症儿童最常见的处方止痛药。这些孩子经历从诊断之时到成年后的疼痛，主要是由于其癌症治疗的疼痛。这大多数儿科癌症患者在大手术治愈或治疗他们的疾病。关于儿童癌症生存的研究更加令人担忧，表明大手术增加新发和慢性阿片类药物的风险。传统的高成本和缺乏可扩展性基于分心的医疗设备来管理疼痛，例如虚拟现实耳机，限制其临床影响和商业潜力。由于癌症患者经常受到免疫功能的影响，因此传染病的风险从共享设备中传输是一种额外的威胁生命，关注的问题。移动增强现实应用程序消除了这些限制，代表了成本效益，安全和重症儿童疼痛管理的商业上可行的辅助工具。我们的目标是减少长期在癌症儿童接受大术手术的儿童中使用的绿核酸，通过用A分散他们的疼痛。在医院康复时，寻宝狩猎风格的移动AR游戏。为了实现这一目标，我们有与儿科肿瘤学家，麻醉学家和痛苦专家合作中心和贝勒医学院（得克萨斯州儿童医院）。在第一阶段，我们将证明调查出现的可行性（增强现实，结合了空间增强）游戏减少住院术后病房中阿片类药物的消耗。在第二阶段，我们将评估该游戏减少正在接受癌症儿童的术后阿片类药物的立即和长期使用在多站点随机对照临床试验中，与治疗相关的主要手术（Aurora试验：增强儿童癌症减少阿片类药物的现实）。据我们所知，这是第一个调查移动的RCT 增加了小儿癌症患者阿片类药物减少的现实或任何术后阿片类药物减少小儿种群。由于预计大多数癌症儿童将长期生存，因此在这种高风险，难治性的疼痛人群中，减少和预防慢性阿片类药物的使用将持续一生一个孩子。