背景:尽管人们对结束持续的阿片类药物健康危机有着强烈和日益增长的兴趣,在降低阿片类药物成瘾的患病率和与阿片类药物过量相关的死亡人数方面取得的成功有限.Further,对此的一种解释是,现有的干预措施针对那些依赖阿片类药物但不能阻止阿片类药物的患者上瘾的人。
目的:利用患者层面的行为经济学可以帮助患者成功使用,中断,并在急性疼痛环境中处置阿片类药物。该项目的主要目标是通过利用务实的随机对照试验(RCT),评估3个版本的阿片类药物管理(OPY)工具对相对于护理标准的阿片类药物使用措施的影响。
方法:来自明尼苏达大学学习健康系统科学中心(CLHSS)的一组研究人员与MHealthFairview合作设计,build,并测试OPY工具的3个版本:社会影响力,预先承诺,和推荐版本。该工具是使用EpicCareCompanion(EpicInc)平台构建的,并通过其现有的MyChart(EpicSystemsCorporation)个人健康记录帐户与患者进行交互,和史诗患者门户,通过手机应用程序或MyChart网站访问。通过将我们的飞行员针对接受上肢手术的特定患者队列,我们已经证明了OPY应用程序社会影响力版本的飞行员数据的可行性。本研究将使用一组序贯RCT设计来测试这一重要卫生系统举措的影响。符合OPY纳入标准的患者将被分层为低,中间,以及根据手术类型使用阿片类药物的高风险。
结果:本研究由CLHSS快速前瞻性评估和数字技术创新计划资助和支持,和M健康锦绣。CLHSS提供的支持和协调包括参与结构,调查开发,数据收集,统计分析,和传播。该项目最初于2022年8月启动。该试点于2023年2月启动,目前仍在运行,数据最后一次统计是在2023年8月。实际的RCT计划于2024年初开始。
结论:通过此RCT,我们将检验我们的假设,即患者阿片类药物的使用和处方阿片类药物的可得性都可以通过行为经济学角度通过直接向阿片类药物使用者的个人健康记录发送轻推来改善信息传递.
背景:ClinicalTrials.govNCT06124079;https://clinicaltrials.gov/study/NCT06124079。
■PRR1-10.2196/52882。
BACKGROUND: Despite 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.
OBJECTIVE: Leveraging 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).
METHODS: A 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.
RESULTS: This 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.
CONCLUSIONS: Through 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.
BACKGROUND: ClinicalTrials.gov NCT06124079; https://clinicaltrials.gov/study/NCT06124079.
UNASSIGNED: PRR1-10.2196/52882.