A Patient-Centered Intervention to Improve Opioid Safety
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Opioid Safety
- Sponsor
- VA Office of Research and Development
- Enrollment
- 286
- Locations
- 1
- Primary Endpoint
- Current Opioid Misuse Measure (COMM)
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This is a randomized controlled trial of a multifaceted intervention designed to improve the safety of opioid prescribing. The specific aims of this study are to: (a) evaluate whether a multifaceted intervention (Improving the Safety of Opioid Prescribing; ISOP) enhances opioid safety, (b) assess whether participation in ISOP impacts the clinician-patient relationship, and (c) explore to what extent ISOP is associated with changes in pain and pain-related function.
Detailed Description
The investigators will randomize primary care providers (PCPs) at the VA Portland Health Care System to either ISOP or the control condition; patients will be nested by clinician status. All PCPs who enroll will participate in either a two-hour educational workshop or the two-hour educational workshop + nurse care manager (NCM). The NCM will maintain a registry of enrolled patients, track opioid medication-related events from the medical record, and provide decision support to PCPs for issues related to prescription opioid safety. The NCM will also meet individually with enrolled participants to discuss strategies for preventing/reducing opioid side effects, preventing diversion, and providing rationale for screening for prescription opioid misuse. The investigators will recruit patients who are already prescribed chronic opioid therapy for chronic non-cancer pain. Participants will be enrolled for one year. Outcomes will be measured at baseline, and 6 and 12 months after enrollment.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Enrollment in primary care at the VA Portland Health Care System
- •Receiving long-term opioid therapy (for at least 3 months) for chronic pain unrelated to a life-limiting disease
- •Able to read and write in English
Exclusion Criteria
- •Age younger than 18 years old
- •On opioid therapy for palliative or end-of-life care
- •Current enrollment in an opioid substitution program
- •Lack of access to a telephone
Outcomes
Primary Outcomes
Current Opioid Misuse Measure (COMM)
Time Frame: Data collected at baseline, 6 months, and 12 months.
The Current Opioid Misuse Measure (COMM) is an assessment of self-reported risk of prescription opioid misuse. There are 17 items, each rated on a scale of 0 (never) to 4 (very often). Total scores range from 0 - 68, with higher scores indicating a greater risk of prescription opioid misuse.
Urine Drug Test
Time Frame: Data collected at baseline, 6 months, and 12 months
Participants will complete urine drug tests (UDTs) to evaluate for presence of substances. UDTs will evaluate for cannabis, cocaine, amphetamines, benzodiazepines, barbiturates, opioids, and opiates. Study results are dichotomous.
Secondary Outcomes
- Chronic Pain Grade(One year)