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Using m-health tools to reduce the misuse of opioid pain relievers
  1. Elise Omaki1,
  2. Renan Castillo1,
  3. Karen Eden2,
  4. Steve Davis3,
  5. Eileen McDonald1,
  6. Umbreen Murtaza4,
  7. Andrea Gielen1
  8. the My Healthy Choices Decision Aid Study Team
    1. 1Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    2. 2Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, USA
    3. 3WVU injury Control and Research Center, West Virginia University, Morgantown, West Virginia, USA
    4. 4Department of Pharmacy, Johns Hopkins Hospital and Health System, Baltimore, Maryland, USA
    1. Correspondence to Elise Omaki, Johns Hopkins Center for Injury Research and Policy, 624 N. Broadway, Baltimore, MD 21205, USA; eperry{at}jhu.edu

    Abstract

    Background Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider.

    Methods This multisite, randomised trial will evaluate an m-health programme designed to aid the patient in making an informed decision about their pain treatment. Patients reporting to the ED with an injury-related or pain- related chief complaint who agree to participate are randomised to receive the intervention programme, My Healthy Choices, or an attention-matched control. My Healthy Choices pairs tailored education with a patient decision aid to describe what opioid and non-opioid pain medications are, assess the patient's risk factors for opioid-related adverse effects, and produce a tailored report that patients are encouraged to share with their doctor. Data are collected through surveys at three time points during the ED encounter (baseline, immediately after the intervention and just before discharge), and at a 6-week follow-up survey. The primary outcomes are whether the patient prefers an opioid pain reliever (OPR) and whether the patient takes an OPR.

    Discussion We hope this programme will facilitate patient-provider communication, as well as reduce the number of prescriptions written for OPRs and thus the number of patients exposed to prescription opioids and the associated risks of addiction and overdose.

    Trial registration number NCT03012087; Pre-results.

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    Footnotes

    • Collaborators In addition to the coauthors, the My Healthy Choices Decision Aid Study Team includes: Wendy Shields, Nicholas Rizzutti, Shannon Frattaroli, James Case, Richard Rothman and Jeff Coben.

    • Contributors EO, the project director, drafted the initial manuscript and edited subsequent drafts. RC and AG, co-PIs for the study, conceptualised the intervention and evaluation and revised and edited the manuscript. KE and EMD developed the intervention and data collection modules. SD and UM developed the sampling criteria and recruitment strategy. All authors edited the manuscript and approve the final submitted version.

    • Funding This work was supported by a grant from the National Center for Injury Control and Prevention, Centers for Disease Control and Prevention (grant number 1R49CE002466).

    • Competing interests None declared.

    • Ethics approval The Institutional Review Board at the Johns Hopkins School of Public Health and the West Virginia University approved this study.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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