Preventing Prescription Stimulant Diversion and Medication Misuse Via a Web-Based Simulation Intervention

通过基于网络的模拟干预防止处方兴奋剂转移和药物滥用

• 批准号: 10404680
• 负责人: Laura Holt
• 金额: $ 11.34万
• 依托单位: TRINITY COLLEGE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10404680
• 关键词: Academic achievement; Accidental Injury; Acquaintances; Adderall; Address; Adult; Advanced Practice Nurse; Area; Attention deficit hyperactivity disorder; Awareness; Behavior; Behavioral; Benzodiazepines; Cardiovascular system; Communication; Computer Simulation; Computers; Consumption; Counseling; Development; Dose; Drug Prescriptions; Emergency department visit; Evidence based intervention; Exposure to; Feedback; Friends; Goals; Headache; Health; Health Personnel; Healthcare; Human Resources; Injury; Insurance Carriers; Intervention; Knowledge; Lead; Learning; Medical; Mental Health; Moods; Morbidity - disease rate; National Institute of Drug Abuse; Online Systems; Opioid; Participant; Perception; Pharmaceutical Preparations; Physiological; Placebos; Planning Theory; Prevalence; Prevention strategy; Privatization; Provider; Psychiatrist; Randomized Controlled Trials; Reporting; Research; Resistance; Risk; Risk Factors; Route; Self Efficacy; Site; Sleeplessness; Stimulant; Strategic Planning; Students; Substance Use Disorder; Symptoms; Testing; Time; addiction; base; behavior change; college; conduct problem; cost; cost effective; disability; drug misuse; emerging adult; epidemiology study; evidence base; follow-up; high risk; illicit drug use; innovation; innovative technologies; intervention effect; intervention participants; medication compliance; medication nonadherence; misuse of prescription only drugs; nonmedical use; pediatrician; peer; pilot test; prescription stimulants; prevent; preventive intervention; primary outcome; psychologic; psychological outcomes; randomized controlled design; response; satisfaction; secondary outcome; sex; side effect; simulation; skill acquisition; skills; social cognitive theory; stimulant misuse; stimulant use; substance use; symptom management; therapy design; university student; vehicular accident; virtual coach; virtual human; web-based intervention

PROJECT SUMMARY College students misuse and divert (i.e., give away, sell, or trade) prescription stimulants more often than any other class of prescription drugs (e.g., opiates). Half or nearly half of college students with prescriptions divert their stimulant medication, and a similarly high percentage misuse their medication (e.g., higher doses, via different routes of administration, etc.) or use someone else’s prescription. Diversion may lead students to go without needed medication to mitigate their symptoms, increasing their risk for unintentional injuries and substance use. Further, diversion perpetuates the non-medical use of prescription stimulants (NMUPS), which has become increasingly common among college students and is associated with other illicit drug use, lower grade point average, insomnia, irritability, headaches, and cardiovascular complications. Diversion also perpetuates medical misuse of stimulants among students with prescriptions, which is associated with poorer ADHD symptom management and may increase the risk for addictive disorders. Despite the fact that nearly 9 out of 10 students obtain prescription stimulants from a friend or acquaintance with a prescription, there are no evidence-based interventions targeting diversion of stimulants in college students. Being approached for one’s medication is a key risk factor for diversion, as is medication non-adherence and believing NMUPS and diversion are more prevalent than they are. Accordingly, in this multi-site study, we will conduct a randomized, controlled trial of 300 college-attending adults with current stimulant prescriptions to examine the preliminary efficacy and feasibility of a single-session, computer-based simulation intervention (with two booster sessions) to prevent prescription stimulant diversion and medication misuse and compare it to a placebo condition. Our intervention, which is grounded in social learning theory, the theory of planned behavior, and our preliminary research, uniquely engages students in interactive discussions with virtual humans to (a) learn about the actual prevalence of NMUPS and diversion and their related risks, (b) practice using refusal strategies when approached for their medication in high-risk situations, and (c) understand how to effectively communicate with prescribers and avoid medication misuse. Our primary aims are to determine if the intervention reduces diversion, intentions to divert, and medication misuse, and to assess user satisfaction with the intervention. Our secondary aims are to examine change in potential mechanisms of action targeted in the intervention, such as self-efficacy to resist diversion, knowledge about diversion and NMUPS, use of behavioral strategies to resist requests for one’s medication, and prescriber communication. Our study responds to PA-17-775, which calls for pilot testing of innovative technology for disseminating effective preventive interventions. It also aligns with NIDA’s Strategic Plan, which encourages the development of preventive interventions that target risk factors for substance use disorders. If effective, the intervention could be readily and widely disseminated to college counseling centers, psychiatrists/APRNs, and pediatricians.

项目概要 大学生滥用和转移（即赠送、出售或交易）处方兴奋剂的情况比任何人都多 一半或近一半持有处方药的大学生会转向其他类别的处方药（例如阿片类药物）。 他们的兴奋剂药物，并且同样高比例的人滥用药物（例如，通过服用更高剂量的药物） 不同的给药途径等）或使用别人的处方可能会导致学生去。 没有必要的药物来减轻症状，增加了意外伤害的风险， 此外，转移使处方兴奋剂 (NMUPS) 的非医疗用途长期存在。 在大学生中变得越来越普遍，并且与其他非法药物的使用有关，较低 平均绩点、失眠、烦躁、头痛和心血管并发症也随之而来。 导致持有处方的学生滥用兴奋剂，这与贫困有关 尽管事实上，多动症症状管理可能会增加成瘾性疾病的风险。 十分之九的学生从朋友或熟人那里开兴奋剂处方， 没有针对大学生兴奋剂转移的循证干预措施。 寻求药物治疗是转移的一个关键风险因素，不遵守药物治疗和 相信 NMUPS 和转移比实际情况更为普遍，因此，在这项多地点研究中，我们将。 对 300 名正在上大学的成年人进行一项随机对照试验，他们目前服用兴奋剂处方 检查基于计算机的单次模拟干预的初步功效和可行性 （两次加强疗程）以防止处方兴奋剂转移和药物滥用并进行比较 我们的干预是基于社会学习理论，即计划理论。 行为以及我们的初步研究，独特地让学生参与虚拟的互动讨论 人类 (a) 了解 NMUPS 和转移的实际流行情况及其相关风险，(b) 实践 在高风险情况下寻求药物治疗时使用拒绝策略，并且 (c) 了解如何 我们的主要目标是确定是否 干预措施减少转移、转移意图和药物滥用，并评估用户满意度 我们的次要目标是研究潜在行动机制的变化。 干预措施，例如抵抗转移的自我效能、有关转移和 NMUPS 的知识、使用 抵制用药请求的行为策略以及处方者沟通。 响应 PA-17-775，该文件呼吁对创新技术进行试点测试，以传播有效的 它还符合 NIDA 的战略计划，该计划鼓励发展 针对药物滥用障碍危险因素的预防性干预措施如果有效，则可以。 易于广泛传播给大学咨询中心、心理医生/APRN 和儿科医生。