Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial

BackgroundDespite strong and growing interest in ending the ongoing opioid health crisis, there has been limited success in reducing the prevalence of opioid addiction and the number of deaths associated with opioid overdoses. Further, 1 explanation for this is that existing...

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Main Authors: Rubina Fatima Rizvi, Jamee Ann Schoephoerster, Sagar Satish Desphande, Michael Usher, Andy Elaine Oien, Maya Marie Peters, Matthew Scott Loth, Matthew William Bahr, Steffen Ventz, Joseph Stephen Koopmeiners, Genevieve B Melton
Format: Article
Language:English
Published: JMIR Publications 2024-03-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2024/1/e52882
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author Rubina Fatima Rizvi
Jamee Ann Schoephoerster
Sagar Satish Desphande
Michael Usher
Andy Elaine Oien
Maya Marie Peters
Matthew Scott Loth
Matthew William Bahr
Steffen Ventz
Joseph Stephen Koopmeiners
Genevieve B Melton
author_facet Rubina Fatima Rizvi
Jamee Ann Schoephoerster
Sagar Satish Desphande
Michael Usher
Andy Elaine Oien
Maya Marie Peters
Matthew Scott Loth
Matthew William Bahr
Steffen Ventz
Joseph Stephen Koopmeiners
Genevieve B Melton
author_sort Rubina Fatima Rizvi
collection DOAJ
description BackgroundDespite strong and growing interest in ending the ongoing opioid health crisis, there has been limited success in reducing the prevalence of opioid addiction and the number of deaths associated with opioid overdoses. Further, 1 explanation for this is that existing interventions target those who are opiate-dependent but do not prevent opioid-naïve patients from becoming addicted. ObjectiveLeveraging behavioral economics at the patient level could help patients successfully use, discontinue, and dispose of their opioid medications in an acute pain setting. The primary goal of this project is to evaluate the effect of the 3 versions of the Opioid Management for You (OPY) tool on measures of opioid use relative to the standard of care by leveraging a pragmatic randomized controlled trial (RCT). MethodsA team of researchers from the Center for Learning Health System Sciences (CLHSS) at the University of Minnesota partnered with M Health Fairview to design, build, and test the 3 versions of the OPY tool: social influence, precommitment, and testimonial version. The tool is being built using the Epic Care Companion (Epic Inc) platform and interacts with the patient through their existing MyChart (Epic Systems Corporation) personal health record account, and Epic patient portal, accessed through a phone app or the MyChart website. We have demonstrated feasibility with pilot data of the social influence version of the OPY app by targeting our pilot to a specific cohort of patients undergoing upper-extremity procedures. This study will use a group sequential RCT design to test the impact of this important health system initiative. Patients who meet OPY inclusion criteria will be stratified into low, intermediate, and high risk of opiate use based on their type of surgery. ResultsThis study is being funded and supported by the CLHSS Rapid Prospective Evaluation and Digital Technology Innovation Programs, and M Health Fairview. Support and coordination provided by CLHSS include the structure of engagement, survey development, data collection, statistical analysis, and dissemination. The project was initially started in August 2022. The pilot was launched in February 2023 and is still running, with the data last counted in August 2023. The actual RCT is planned to start by early 2024. ConclusionsThrough this RCT, we will test our hypothesis that patient opioid use and diverted prescription opioid availability can both be improved by information delivery applied through a behavioral economics lens via sending nudges directly to the opioid users through their personal health record. Trial RegistrationClinicalTrials.gov NCT06124079; https://clinicaltrials.gov/study/NCT06124079 International Registered Report Identifier (IRRID)PRR1-10.2196/52882
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spelling doaj.art-fd66c7e0c69d4c889b7002c412bdbdae2024-03-08T13:30:33ZengJMIR PublicationsJMIR Research Protocols1929-07482024-03-0113e5288210.2196/52882Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled TrialRubina Fatima Rizvihttps://orcid.org/0000-0001-9432-3086Jamee Ann Schoephoersterhttps://orcid.org/0000-0002-0037-1480Sagar Satish Desphandehttps://orcid.org/0000-0002-6130-613XMichael Usherhttps://orcid.org/0000-0002-0205-987XAndy Elaine Oienhttps://orcid.org/0009-0000-0030-4483Maya Marie Petershttps://orcid.org/0000-0003-4603-1948Matthew Scott Lothhttps://orcid.org/0000-0002-7777-9919Matthew William Bahrhttps://orcid.org/0009-0009-2813-7619Steffen Ventzhttps://orcid.org/0000-0003-2229-9560Joseph Stephen Koopmeinershttps://orcid.org/0000-0001-6147-3168Genevieve B Meltonhttps://orcid.org/0000-0001-5193-1663 BackgroundDespite strong and growing interest in ending the ongoing opioid health crisis, there has been limited success in reducing the prevalence of opioid addiction and the number of deaths associated with opioid overdoses. Further, 1 explanation for this is that existing interventions target those who are opiate-dependent but do not prevent opioid-naïve patients from becoming addicted. ObjectiveLeveraging behavioral economics at the patient level could help patients successfully use, discontinue, and dispose of their opioid medications in an acute pain setting. The primary goal of this project is to evaluate the effect of the 3 versions of the Opioid Management for You (OPY) tool on measures of opioid use relative to the standard of care by leveraging a pragmatic randomized controlled trial (RCT). MethodsA team of researchers from the Center for Learning Health System Sciences (CLHSS) at the University of Minnesota partnered with M Health Fairview to design, build, and test the 3 versions of the OPY tool: social influence, precommitment, and testimonial version. The tool is being built using the Epic Care Companion (Epic Inc) platform and interacts with the patient through their existing MyChart (Epic Systems Corporation) personal health record account, and Epic patient portal, accessed through a phone app or the MyChart website. We have demonstrated feasibility with pilot data of the social influence version of the OPY app by targeting our pilot to a specific cohort of patients undergoing upper-extremity procedures. This study will use a group sequential RCT design to test the impact of this important health system initiative. Patients who meet OPY inclusion criteria will be stratified into low, intermediate, and high risk of opiate use based on their type of surgery. ResultsThis study is being funded and supported by the CLHSS Rapid Prospective Evaluation and Digital Technology Innovation Programs, and M Health Fairview. Support and coordination provided by CLHSS include the structure of engagement, survey development, data collection, statistical analysis, and dissemination. The project was initially started in August 2022. The pilot was launched in February 2023 and is still running, with the data last counted in August 2023. The actual RCT is planned to start by early 2024. ConclusionsThrough this RCT, we will test our hypothesis that patient opioid use and diverted prescription opioid availability can both be improved by information delivery applied through a behavioral economics lens via sending nudges directly to the opioid users through their personal health record. Trial RegistrationClinicalTrials.gov NCT06124079; https://clinicaltrials.gov/study/NCT06124079 International Registered Report Identifier (IRRID)PRR1-10.2196/52882https://www.researchprotocols.org/2024/1/e52882
spellingShingle Rubina Fatima Rizvi
Jamee Ann Schoephoerster
Sagar Satish Desphande
Michael Usher
Andy Elaine Oien
Maya Marie Peters
Matthew Scott Loth
Matthew William Bahr
Steffen Ventz
Joseph Stephen Koopmeiners
Genevieve B Melton
Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
JMIR Research Protocols
title Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
title_full Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
title_fullStr Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
title_full_unstemmed Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
title_short Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution: Protocol for a Randomized Controlled Trial
title_sort decreasing opioid addiction and diversion using behavioral economics applied through a digital engagement solution protocol for a randomized controlled trial
url https://www.researchprotocols.org/2024/1/e52882
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