Preventing Prescription Drug Problems: A Pilot Military Opioid Safety Initiative

预防处方药问题：军事阿片类药物安全试点计划

基本信息

批准号：
8731857
负责人：
Mary Jo Larson
金额：
$ 30.78万
依托单位：
BRANDEIS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-15 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8731857
关键词：
Academic Detailing Adoption Adult Afghanistan Alcohols Behavior Censuses Communities Community Hospitals Community Physician County Data Dose Drug Monitoring Drug Prescriptions Education Educational Intervention Educational Materials Effectiveness Enrollment Environment Family Family member Future Goals Intervention Iraq Literature Measures Medical Education Medical center Military Personnel Monitor Morphine Opioid Outcome Outcome Measure Overdose Patients Pharmaceutical Preparations Pharmacists Physicians Pilot Projects Population Practice Management Preclinical Drug Evaluation Prevention Primary Care Physician Recruitment Activity Reporting Resources Risk Safety Schedule South Carolina System Testing United States Department of Veterans Affairs Universities Veterans Visit Workplace arm base clinical practice design drug testing health care quality high risk improved innovation member milligram misuse of prescription only drugs outreach overdose death prevent programs public health relevance randomized trial retiree secondary outcome

项目摘要

DESCRIPTION (provided by applicant): Brandeis University and University of South Carolina (SC) are proposing a pilot study, the SC Opioid Safety Initiative - Military (SCOSI-M) study, that will focus on increasing the use of safe prescribing and prescription monitoring practices among primary care physicians. We will design an innovative educational intervention using an academic detailing approach that has military/veteran-specific content and is targeted to physicians treating military personnel and veterans. This project fills a gap because currently, no academic detailing programs specific to controlled substances are in the literature. A second innovation is that we will promote the use of the SC prescription drug monitoring program (PDMP) as one of the educational objectives. This increases the study's significance and potential generalizability, as state PDMP programs are widespread and have been shown to reduce diversion of controlled substances. Their effectiveness in improving quality of health care is hindered; however, as very few prescribers use them. The overall aim of SCOSI-M is to prevent the onset or progression of prescription drug problems among Iraq and Afghanistan veterans, military members, and their families who are at high risk for developing problems if their treatment involves long-term use of an opioid. The specific aims are to: Aim 1. Design an educational outreach intervention based on academic detailing (i.e., SCOSI-M) for physicians with content specific to prescription drug problems among veterans, military members, and their families. Aim 2. Enroll in SCOSI-M 112 physicians from 3 environments who currently serve veterans, military members, and their families and who also routinely prescribe Schedule II opioids, and engage them in a 2-visit intervention. Aim 3. To evaluate the feasibility and effectiveness of the SCOSI-M intervention. Feasibility relates to reaching targeted physicians and engaging them in SCOSI-M. Effectiveness is measured by physicians registering for and use of the South Carolina Reporting & Identification Prescription Tracking System (SCRIPTS) when prescribing opioids (e.g., % of new patients the physician queried). Secondary outcomes are measures of safer prescribing practices (% of patients prescribed 100 morphine milligram equivalents or more per day), adoption of other prescription management practices (administer alcohol/drug screen, order drug tests). Exploratory outcomes are the association of the intervention with prescription drug misuse or abuse measures for the military population and overall adult population of Richland County, SC. A successful R34 pilot study will inform the design of a future large-scale randomized trial to assess the effectiveness of academic detailing combined with increased PDMP use in reducing prescription drug misuse.

描述（由申请人提供）：布兰代斯大学和南卡罗来纳大学 (SC) 正在提议一项试点研究，即 SC 阿片类药物安全倡议 - 军事 (SCOSI-M) 研究，该研究将重点关注增加安全处方和处方监测的使用初级保健医生的实践。我们将使用学术细节方法设计创新的教育干预措施，该方法具有军事/退伍军人特定的内容，并针对治疗军事人员和退伍军人的医生。该项目填补了一项空白，因为目前还没有文献中有针对受控物质的学术详细计划。第二个创新是我们将推广使用 SC 处方药监测计划（PDMP）作为教育目标之一。这增加了该研究的重要性和潜在的普遍性，因为州 PDMP 计划非常广泛，并且已被证明可以减少受控物质的转移。它们在提高医疗保健质量方面的有效性受到阻碍；然而，很少有处方者使用它们。 SCOSI-M 的总体目标是防止伊拉克和阿富汗退伍军人、军人及其家人出现或发展处方药问题，如果他们的治疗涉及长期使用阿片类药物，他们将面临出现问题的高风险。具体目标是：目标 1. 为医生设计基于学术细节（即 SCOSI-M）的教育外展干预措施，内容针对退伍军人、军人及其家人的处方药问题。目标 2. 将来自 3 个环境的 112 名医生纳入 SCOSI-M，这些医生目前为退伍军人、军人及其家人提供服务，并且还经常开二类阿片类药物，并让他们参与 2 次就诊干预。目标 3. 评估 SCOSI-M 干预的可行性和有效性。可行性涉及接触目标医生并让他们参与 SCOSI-M。有效性是通过在开阿片类药物处方时注册和使用南卡罗来纳州报告和识别处方跟踪系统 (SCRIPTS) 的医生来衡量的（例如，医生询问的新患者的百分比）。次要结果是更安全的处方实践措施（每天开出 100 毫克当量或更多吗啡的患者百分比）、采用其他处方管理实践（进行酒精/药物筛查、安排药物测试）。探索性结果是干预措施与南卡罗来纳州里奇兰县军人和总体成年人口处方药误用或滥用措施的关联。成功的 R34 试点研究将为未来大规模随机试验的设计提供信息，以评估学术细节与增加 PDMP 使用在减少处方药滥用方面的有效性。