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

项目总结/摘要 在过去十年中，向美国青年开出的阿片类药物处方数量增加了一倍多。在同一 在此期间，严重的阿片类药物相关不良事件（ADE）飙升，包括数千名住院患者 每年都有数百人因服药过量而意外死亡此外，最近的估计表明， 平均每天有2500名美国青少年将首次滥用阿片类药物。数量惊人 ADE和在青年中的广泛滥用在很大程度上反映了对潜在的 阿片类药物的危害我们和其他人以前已经表明，父母的理解不足会导致风险和 潜在危险的处方阿片类药物相关的决定，包括给予药物的儿童有迹象， 毒性，疼痛管理不足，以及阿片类药物储存和处置行为不当。因此，在本发明中， 改变提供者在阿片类药物处方时提供风险信息的方式至关重要， 提高儿童和青少年家庭使用这些强效镇痛药的安全性。总体目标 我们的研究是通过优化阿片类药物风险识别来提高阿片类镇痛药的安全性和有效性， 知情的止痛决策，和药物储存/处置行为的青少年的父母谁是 开了这些药剂供家庭使用通过此提案，我们的目标是证明我们的情景定制 阿片类药物信息传递计划（STOMP™）将：1）提高父母对阿片类药物风险的认识， 2）提高父母的镇痛自我效能感、镇痛药物的使用、储存行为及其对镇痛药物的影响。 3）证明STOMP™加上提供一种方法，以摆脱儿童的疼痛结果， 剩余药物将有效地促使父母安全地处理剩余的阿片类止痛药。父母 其5-17岁的儿童在门诊、骨科手术后因急性、短暂疼痛而服用阿片类药物， 手术将被随机分配接受我们的干预或常规提供者信息互动， 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，镇痛药的决定和使用，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对照组， 有效和高效的手段，以优化父母的阿片类药物相关的风险降低决策和行为， 提高他们控制孩子疼痛的能力。我们的创新研究将提供重要数据， 告知提供者如何提高父母的阿片类镇痛药风险知识，这反过来将促进安全， 在儿童和青少年家中有效使用阿片类镇痛剂。

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.