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.
Public Health Relevance: Millions of children and adolescents are prescribed opioid pain relievers each year, placing them at risk for serious adverse events and misuse in the home setting. Parents who manage these medicines, therefore, need to recognize opioid-related risks and make decisions that will both reduce these risks yet ensure effective pain relief for their children. The proposed research will evaluate new strategies to help parents learn about opioid risks, make safe and effective analgesic decisions, and develop and demonstrate safe drug management behaviors. As such, this research promises to provide new approaches that will promote the safe and effective use of opioid analgesics for children and adolescents who need them.
| Voepel-Lewis, Terri; Zikmund-Fisher, Brian J; Boyd, Carol J et al. (2018) Effect of a Scenario-tailored Opioid Messaging Program on Parents' Risk Perceptions and Opioid Decision-making. Clin J Pain 34:497-504 |
| McCabe, Sean Esteban; Wilens, Timothy E; Boyd, Carol J et al. (2018) Age-specific risk of substance use disorders associated with controlled medication use and misuse subtypes in the United States. Addict Behav 90:285-293 |
