Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills

Area of Science:

• Pain Management
• Digital Health
• Pharmacology

Background:

• Opioid analgesics are frequently prescribed on an as-needed (PRN) basis for acute pain.
• Variable prescribing and patient use patterns contribute to surplus opioids, increasing risks of diversion and nonmedical use.
• Understanding actual opioid ingestion is crucial for safe prescribing and addiction prevention.

Purpose of the Study:

• To evaluate the utility of a novel digital pill system in capturing opioid utilization patterns in patients with acute fracture pain.
• To assess variability in opioid self-dosing among patients discharged from the emergency department with acute pain.

Main Methods:

• A digital pill system with an ingestible biosensor was used to record oxycodone ingestion in opioid-naive patients with acute fracture pain.
• Participants received 5-mg oxycodone digital pills and instructions for PRN use.
• Ingestion events were captured in real-time via a wearable reader and cloud-based server; pill counts validated data.

Main Results:

• Fifteen participants completed the study, ingesting a median of 6 oxycodone pills over 7 days, with 82% of the dose taken in the first 3 days.
• Significant variability in ingestion patterns was observed between individuals.
• Opioid use extended to 1 week for patients requiring operative repair, with 86% continuing ingestion.

Conclusions:

• A digital pill system effectively captured opioid utilization patterns in patients with acute fracture pain, showing a median use of 45-mg morphine equivalents over 7 days.
• Opioid self-dosing patterns varied substantially, with some patients ceasing use within 4 days.
• The system demonstrated the ability to measure changes and variability in patient opioid self-dosing, informing clinical practice.