Patient Perspectives on Prescription Opioid Discontinuation: Understanding and Promoting Safe Transitions
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Kaiser Permanente
- Enrollment
- 30
- Locations
- 2
- Primary Endpoint
- Acceptability of DA
Study Overview
Brief Summary
Because of recent policies to decrease opioid use, some people using long-term opioid therapy (LTOT) are encouraged or required to stop (discontinue) taking opioids. That has led experts to be concerned that patients whose LTOT is discontinued could have untreated pain, turn to other substance use and possibly illicit opioids, or have worsened mental health symptoms leading to suicide. To guide safer policies, guidelines, and care, this study will interview patients and doctors about discontinuing LTOT and use the results to develop a patient-centered decision aid (DA) to improve patient-provider communication around discontinuation of LTOT. Once the DA is finalized, it will be pilot tested with a group of 30 patients who are currently on LTOT. The pilot will assess DA implementation feasibility; acceptability; knowledge transfer; and ability to successfully foster positive, patient-centered conversations about opioid discontinuation.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •EHR-based inclusion criteria:
- •age 18 or older
- •LTOT in the past 18 months (LTOT is ≥60 days of ≥50 MEDs day in each of 2 consecutive 90-day periods with medication treatment for OUD excluded)
- •Inclusion criteria confirmed by participant
- •Have been taking opioids for chronic pain for at least 6 months
- •Able to speak and read English
Exclusion Criteria
- •cancer diagnosis in the last 5 years (excluding non-melanoma skin cancers)
- •current palliative or hospice care
- •cognitive disability
- •psychiatric hospitalization in the last year
- •surgery in the last 6 months
- •current residence in an inpatient rehabilitation or skilled nursing facility
- •Exclusion criteria determined by study
- •- participated in an interview for Aim 1 of this study
Arms & Interventions
Decision Aid Pilot Test
Intervention: Patient-centered Decision Aid to support long-term opioid therapy tapering (Behavioral)
Outcomes
Primary Outcomes
Acceptability of DA
Time Frame: 1-2 weeks
We will use Matlock et al.'s acceptability ranking scale to assess the acceptability of the DA to patients
Acceptability of DA
Time Frame: 1-2 weeks
We will use Matlock et al.'s acceptability ranking scale to assess the acceptability of the DA to patients
Secondary Outcomes
No secondary outcomes reported
Investigators
Clarissa Hsu
Associate Investigator
Kaiser Permanente