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This study will develop a technology-based brief educational intervention for hospitalized patients that will be discharged with an opioid prescription. The Investigators will conduct a small randomized clinical trial of T-POSE to determine whether it improves patients: knowledge and reduces the incidence of Non-Medical Prescription Opioid Use (NMPOU).
Non-medical use of prescription opioids (NMPOU) can be generally defined as not taking opioids as prescribed, which could occur unintentionally or intentionally. In 2014, 4.3 million adults in the United States (U.S.) were estimated to engage in NMPOU (Center for Behavioral Health Statistics and Quality 2014). Some patients may take a dose more frequently than prescribed because they were not receiving adequate pain relief from the prescribed dosage. While others may continue to take opioids longer than prescribed because their pain is persistent and/or they like the euphoric effects of opioids. According to a recently released Truven Health Analytics-NPR Health Poll, the majority (57%) of Americans have taken a prescription opioid and 35% of those had concerns (e.g., addiction, effectiveness, side effects) about prescription opioids. These findings suggest that while Americans are aware, some even concerned, of the potential dangers associated with prescription opioids that their utilization patterns continue to increase (Boddy 2017). Because opioids are prescribed by a physician, patients may believe that these medications are safe and they may be unaware of the risks associated with misuse and abuse of opioids. NMPOU may lead to increased risk of drug overdose, addiction, diversion and use of heroin. Many individuals with opioid use disorders initiated NMPOU before transitioning to heroin (Banerjee et al. 2016; Cerda et al. 2015) and report that their first exposure to an opioid was prescribed by a physician. This underscores the need for empirically-tested educational interventions that can potentially reduce NMPOU and diversion. Prescription opioids have an important role to play in health care and blanket policies to restrict access to prescription opioids are not appropriate, rather the hypothesis is that harm can be reduced by fundamentally changing our approach to opioid medication safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| T-POSE | Experimental | Technology based brief educational intervention for hospitalized patients that will be discharged with an opioid prescription. |
|
| Usual Care | Other | Standard discharge instructions provided. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| T-POSE | Other | Tablet based education and videos on opioid safety, use, and storage/disposal of the drug. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of Non-Medical Use of a Prescription Opioid | Self report of Yes or No to follow up questions about prescription opioid use. Yes= occurrence of Non-Medical Use of a Prescription Opioid. | Up to 90 days post intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of retention of knowledge on how to safe use of prescription opioids | The number of times that a patient reports retention of materials presented. | Up to 90 days post intervention |
| Number of patients reporting patient satisfaction |
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Phase I Inclusion Criteria:
Phase II Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Erin Winstanley, PhD | West Virginia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cabell Huntington Hospital (Marshall University) | Huntington | West Virginia | 25755 | United States | ||
| West Virginia University Hospitals |
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A small pilot study using a randomized clinical trial of T-POSE compared to usual care.
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| Usual Care | Other | Printed instruction sheets on prescribed opioid. |
|
Overall number of subjects satisfied with T-POSE, as measured by a 5-point Patient Satisfaction questionnaire.
| Up to 90 days post intervention |
| Reasons for non-medical use of prescription opioids | Investigators recorded reasons for non-medical us of prescription opioids. | Up to 90 days post intervention |
| Morgantown |
| West Virginia |
| 26505 |
| United States |