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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：
10027245
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 2020-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10027245
关键词：
Address Adverse event Afghanistan Alcohol consumption Alcohol or Other Drugs use Attention Behavior Behavior Therapy Behavioral Caring Cessation of life Clinic Cognitive Complement Conflict (Psychology)Controlled Study Data Dose Elements Emergency department visit Ensure Future General Population Health Personnel Healthcare Systems Injury Intervention Iraq Knowledge Location Measures Mediator of activation protein Mental Health Modality Motivation Opioid Opioid Analgesics Outcome Overdose Pain Pain management Pain quality Participant Patient Care Patient Self-Report Patients Personal Satisfaction Pharmaceutical Preparations Pharmacy facility Prescription opioid overdose Preventive Intervention Primary Health Care Provider Public Health Randomized Randomized Controlled Trials Records Reporting Risk Risk Behaviors Risk Reduction Safety Sedation procedure Self Efficacy Services United States Veterans Violence adverse outcome behavior change behavioral health brief intervention care providers chronic pain coping evidence base follow-up health administration improved intervention effect morphine equivalent opioid mortality opioid overdose opioid therapy opioid use overdose prevention overdose risk pill pragmatic trial prescription opioid prevent recruit therapy design 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