Decreasing Opioid Addiction and Diversion Using Behavioral Economics Applied Through a Digital Engagement Solution:...

Area of Science:

• Behavioral Economics
• Digital Health Interventions
• Public Health

Background:

• The opioid crisis persists despite growing interest in solutions.
• Existing interventions often fail to prevent addiction in opioid-naïve patients.
• Novel approaches are needed to manage opioid use and prevent misuse.

Purpose of the Study:

• To evaluate the effectiveness of three versions of the Opioid Management for You (OPY) tool.
• To assess the impact of behavioral economics principles on patient opioid management.
• To reduce opioid use and diversion in acute pain settings through a pragmatic randomized controlled trial (RCT).

Main Methods:

• Development and testing of three OPY tool versions (social influence, precommitment, testimonial) on the Epic Care Companion platform.
• Utilizing patients' existing MyChart personal health record accounts for tool interaction.
• Employing a group sequential RCT design, stratifying patients by opioid use risk based on surgical type.

Main Results:

• Pilot feasibility demonstrated with the social influence version in patients undergoing upper-extremity procedures.
• The study is funded and supported by the Center for Learning Health System Sciences (CLHSS) and M Health Fairview.
• The pilot phase ran from February 2023 to August 2023, with the main RCT planned for early 2024.

Conclusions:

• The RCT will test if behavioral economics-informed nudges delivered via personal health records can decrease patient opioid consumption.
• The study hypothesizes that these interventions will also reduce the availability of diverted prescription opioids.
• This approach aims to improve both individual patient outcomes and broader public health regarding opioid misuse.