Screen-and-treat in trauma for opioid misuse prevention using an adaptive intervention (STOMP-AI): Protocol for a...

Area of Science:

• Trauma care research
• Addiction medicine
• Pain management

Background:

• Opioid misuse is a significant risk for trauma patients, exacerbated by uncontrolled pain and distress.
• Heterogeneity in risk factors necessitates personalized interventions, but adaptive intervention feasibility is unexplored.
• Current approaches lack tailored strategies for mitigating opioid misuse post-traumatic injury.

Purpose of the Study:

• To determine the feasibility and acceptability of delivering an adaptive intervention for patients hospitalized with traumatic injuries.
• To evaluate the feasibility of a pilot sequential, multiple-assignment randomized trial (SMART) design for this population.
• To inform the development of a refined adaptive intervention and SMART protocol for future optimization-effectiveness trials.

Main Methods:

• A pilot sequential, multiple-assignment randomized trial (SMART) involving 107 patients across two Level I trauma centers.
• Intervention includes opioid risk monitoring, trauma care coordination, and pain coping skills training, initiated within one week of discharge.
• Feasibility assessed through recruitment, retention, randomization, data collection, and qualitative methods.

Main Results:

• Pilot data will assess the feasibility and acceptability of adaptive intervention components.
• Data will inform the practicality and success of the SMART design in a clinical setting.
• Feasibility metrics will guide refinement of intervention delivery and trial procedures.

Conclusions:

• Pilot data is crucial for refining a manualized adaptive intervention.
• A fully developed SMART protocol will be established for future large-scale trials.
• This research lays the groundwork for optimizing interventions to reduce opioid misuse in trauma survivors.