Statement of purpose Preventing opioid misuse and opioid use disorder (OUD) is necessary given the opioid epidemic. Prevention programs for adolescents/young adults are needed to alter risk trajectories. We developed interventions using telemedicine (synchronous video conference) and a patient portal-like messaging system to address risk factors for opioid misuse/OUD among young Emergency Department (ED) patients. Our presentation describes these promising interventions and their feasibility and acceptability.
Methods/Approach In Spring 2020, N = 40 ED patients ages 16–30 who were at risk for opioid misuse/OUD enrolled in a pilot trial involving screening/baseline assessments, motivational interviewing-based remote interventions (baseline telemedicine brief intervention [BI], 1-month of portal messaging), and a 1-month follow-up. Before COVID-19, N = 10 enrolled in the ED (in-person cohort: IPC); during COVID-19, N = 30 recent ED patients enrolled via phone recruitment (remote cohort: RC). Feasibility data are presented by cohort; acceptability data are combined.
Results Among the N=40, the sample had a mean age of 22.9 years. Gender was: 70% female, 5% non-conforming, 25% male. Race was: 75% White, 15% Black/African American, and 10% other racial identities; 17.5% were Hispanic/Latinx. Regarding feasibility, eligibility rates were similar (IPC: 17%, RC: 15%); consenting rates differed (IPC: 100%, RC: 56%), likely due to the RC’s telephone approach. Portal engagement increased from the IPC (60%) to the RC (93%), possibly due to addressing technical difficulties and IPC user feedback. BI and portal satisfaction were high (M = 9.3 on a 1–10 scale and M = 8.5, respectively). Interventions exceeded motivational interviewing fidelity thresholds (adapted for portal messaging). Follow-up rates were high (IPC: 80%, RC: 93%).
Significance Preventing opioid misuse is critical to avoiding escalation of opioid use and overdoses, and emergency department patients are at increased risk. This study demonstrates the feasibility and acceptability of these intervention approaches via telemedicine for preventing future injuries.
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