Government Direct-to-Consumer Education to Reduce Prescription Opioid Use: A Cluster Randomized Clinical Trial

Area of Science:

• Public Health
• Pain Management
• Clinical Trials

Background:

• Direct-to-consumer education has reduced sedative use, but its impact on prescription opioid use for chronic noncancer pain is unknown.
• Long-term opioid consumers with chronic noncancer pain represent a population where educational interventions may be beneficial.

Purpose of the Study:

• To assess if a mailed educational brochure from a government entity can reduce prescription opioid use among long-term opioid consumers.
• To compare the effectiveness of this educational intervention against usual care in a community-dwelling population.

Main Methods:

• A cluster randomized clinical trial involving 4225 adults with long-term opioid prescriptions in Manitoba, Canada.
• Participants were randomized to receive an educational brochure (intervention) or usual care (control).
• Opioid cessation and dose reduction (morphine milligram equivalents) were measured at 6 months via pharmacy claims.

Main Results:

• No significant difference in opioid cessation rates was found between the intervention (11.0%) and control (11.0%) groups after 6 months.
• More participants in the intervention group reduced their opioid dose (66.0%) compared to the control group (63.1%).
• Subgroup analyses showed greater dose reductions in males, younger adults (18-64), and urban dwellers receiving the brochure.

Conclusions:

• Mailed educational brochures did not significantly increase prescription opioid cessation in long-term users with chronic noncancer pain.
• The intervention was associated with a modest increase in opioid dose reduction, particularly in specific demographic subgroups.
• Further research may explore tailored educational strategies for optimizing opioid use reduction.