Feasibility of a dual English/Spanish mobile augmented reality pain assessment app to reduce postoperative prescription opioid use in Hispanic/Latino pediatric and adolescent cancer patients

英语/西班牙语双移动增强现实疼痛评估应用程序减少西班牙裔/拉丁裔儿童和青少年癌症患者术后处方阿片类药物使用的可行性

• 批准号: 10741922
• 负责人: Juan Pablo Cata
• 金额: $ 5.5万
• 依托单位: ALTALITY, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-06 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10741922
• 关键词: Acute Pain; Adolescent; Adult; Adverse event; Age; Anesthesia procedures; Assessment tool; Augmented Reality; Cancer Center; Cancer Patient; Caregivers; Caring; Child; Childhood; Chronic; Clinical; Collaborations; Communication; Dependence; Diagnosis; Disease; Exposure to; Family; Family member; Future; Goals; Hispanic; Hospitals; Income; Inpatients; Institution; Language; Latino; Limited English Proficiency; Malignant Childhood Neoplasm; Malignant Neoplasms; Medical; Methods; Minority Groups; Nausea and Vomiting; Not Hispanic or Latino; Operative Surgical Procedures; Opiate Addiction; Pain; Pain Measurement; Pain intensity; Pain management; Patients; Perioperative; Phase I Clinical Trials; Population; Postoperative Pain; Postoperative Period; Services; Small Business Innovation Research Grant; Specialist; Substance abuse problem; Survivors; Time; Translations; United States; Youth; acute care; assessment application; bilingualism; cost; experience; high risk; opioid misuse; opioid use; overtreatment; parent grant; pediatric patients; prescription opioid; prescription opioid addiction; prescription opioid misuse; prevent; tool; verbal

PROJECT SUMMARY/ABSTRACT OF PARENT GRANT Hispanic/Latino youth are at the highest risk for prescription opioid misuse for pain indications amongst all minority populations in the United States. There are few legitimate clinical indications for prescribing opioids to children and adolescents, as early opioid use is a known “gateway” to adulthood dependence and substance abuse disorders. Cancer and major surgery are two critical medical conditions that when put together, cause children and adolescents to experience significant pain from the time of diagnosis into adulthood as survivors and put them at higher risk for persistent and chronic prescription opioid use and dependency. In perioperative settings, clinical decisions on opioid prescribing are dependent on rapid, verbal communication of pain intensity levels and adverse events between the clinical staff, the pediatric patient, and most often, family members in the acute care setting. Spanish-speaking Hispanic/Latino patients and/or adult caregivers with limited English proficiency are forced to rely on the availability of institutional translation services or the presence of bilingual clinical staff, which may not be readily available or easy to use. These infrastructural barriers, exacerbated in low or middle-income hospitals, put these patients at higher risk of inaccurate pain assessments, both under and over-treatment of their pain, and exposure to inappropriate amounts of prescription opioids. Our goal is to reduce inaccurate assessment and treatment of pain and opioid prescribing in Hispanic/Latino children and adolescents with cancer undergoing major surgery with a rapid, dual English/Spanish-language, age-appropriate, engaging mobile augmented reality (AR) tool that can help them and their families to communicate information about their acute pain and pain-related adverse events in the immediate postoperative inpatient setting. To achieve this goal, we have collaborated with bilingual native Spanish- speaking pediatric anesthesiologists and pain specialists at the MD Anderson Cancer Center to develop the app with content relevant and engaging to Hispanic and non-Hispanic pediatric populations and will demonstrate the feasibility of implementing the app in the postoperative anesthesia care unit in a Phase I clinical trial. To our knowledge, there are no studies to investigate mobile AR for enhancing pain management focused on this population. As most children with cancer are expected to survive long-term, the benefits of preventing inappropriate prescription opioid use in this high-risk pain population will last over the lifetime of a child.

父母赠款的项目摘要/摘要 西班牙裔/拉丁裔青年在所有人之间处方痛苦的处方痛苦的风险最高 美国的少数民族人口。开处阿片类药物的合法临床适应症几乎没有 儿童和青少年，由于早期使用阿片类药物是对成年依赖性和主题的已知“门户” 滥用障碍。癌症和大型手术是两个关键的医疗条件，当融合在一起时， 从诊断之时到成年后，儿童和青少年作为生存而感到重大疼痛 并将其持续使用和慢性处方使用和依赖性的风险更高。定期 设置，阿片类药物处方的临床决定取决于疼痛强度的快速，口头交流 临床人员，儿科患者以及最常见的家庭成员之间的水平和不良事件 急性护理设置。说西班牙语的西班牙裔/拉丁裔患者和/或英语有限的成人护理人员 熟练程度被迫依靠机构翻译服务的可用性或双语的存在 临床人员，可能不容易获得或易于使用。这些基础设施障碍，加剧了 低收入或中等收入医院，使这些患者处于疼痛评估不准确的风险之下 和过度治疗疼痛，并暴露于不适当的处方阿片类药物。 我们的目标是减少西班牙裔/拉丁裔的疼痛和阿片类药物处方的评估和治疗 患有癌症的儿童和青少年正在接受大手术，并以快速，双重英语/西班牙语的方式进行 适合年龄的，引人入胜的移动增强现实（AR）工具，可以帮助他们及其家人 传达有关其急性疼痛和与疼痛有关的不良事件的信息 术后住院设置。为了实现这一目标，我们已经与双语的西班牙人合作 在MD安德森癌症中心讲的小儿麻醉师和疼痛专家 与西班牙裔和非西班牙裔儿科人群相关的内容和参与的应用程序 证明在I期中在术后麻醉护理单元中实施该应用的可行性 临床试验。据我们所知，没有研究调查移动AR来增强疼痛管理 专注于这个人群。由于预计大多数癌症儿童将长期生存，因此 防止在这种高风险疼痛人群中使用不适当的处方OID使用，将持续一生 孩子。