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

项目概要/赠款摘要 西班牙裔/拉丁裔青年在所有人中滥用处方阿片类药物治疗疼痛的风险最高 美国的少数民族。处方阿片类药物的合法临床适应症很少， 儿童和青少年，因为早期使用阿片类药物是已知的成年依赖和物质的“门户”， 滥用障碍癌症和大手术是两个关键的医疗条件，当放在一起， 儿童和青少年从诊断到成年作为幸存者经历显著的疼痛 并使他们处于持续和慢性处方阿片类药物使用和依赖的更高风险。围手术 阿片类药物处方的临床决策取决于疼痛强度的快速口头沟通 水平和不良事件之间的临床工作人员，儿科患者，最常见的是，家庭成员， 急诊护理环境。讲西班牙语的西班牙裔/拉丁裔患者和/或英语水平有限的成人护理人员 熟练程度被迫依赖于机构翻译服务的可用性或双语的存在 临床工作人员，这可能不是现成的或易于使用。这些基础设施障碍， 低收入或中等收入的医院，使这些患者在不准确的疼痛评估的风险更高， 过度治疗他们的疼痛，以及接触不适当数量的处方阿片类药物。 我们的目标是减少西班牙裔/拉丁裔患者对疼痛和阿片类药物处方的不准确评估和治疗 患有癌症的儿童和青少年接受大手术，使用快速的英语/西班牙语双语， 适合年龄的、吸引人的移动的增强现实（AR）工具，可以帮助他们及其家人 立即传达有关其急性疼痛和疼痛相关不良事件的信息 术后住院环境。为了实现这一目标，我们与双语母语西班牙语- 在MD安德森癌症中心的儿科麻醉师和疼痛专家的演讲中， 内容与西班牙裔和非西班牙裔儿科人群相关并具有吸引力的应用程序， 证明在第一阶段的术后麻醉监护室实施应用程序的可行性 临床试验据我们所知，没有研究调查移动的AR用于增强疼痛管理 专注于这个人群。由于大多数癌症儿童有望长期生存， 防止在这一高风险疼痛人群中不适当的处方阿片类药物使用将持续一生， 孩子

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.