Randomized comparison of two web-based interventions on immediate and 30-day opioid overdose knowledge in three unique risk groups

Abstract

Background: In response to the opioid overdose epidemic, scalable interventions that instruct at-risk populations how to prevent and respond to overdose scenarios are needed.

Method: The following groups of at-risk individuals were recruited online: (1) Acute Pain patients with an opioid prescription, (2) Chronic Pain patients with an opioid prescription, and (3) persons without pain who use Illicit Opioids. Participants were tested on their opioid overdose knowledge using the Brief Opioid Overdose Knowledge (BOOK) questionnaire and randomized to one of two web-based interventions that contained 25 educational content slides. One intervention consisted of embedded questions with corrective feedback (Presentation + Mastery, n = 58), the other did not (Presentation, n = 61). Participants completed the BOOK again at the end of the intervention and 30 days later. Overdose risk behaviors were assessed at baseline and 30-days.

Results: Relative to baseline, both Presentation and Presentation + Mastery interventions increased total BOOK scores immediately and 30 days later. There was a significant effect of Group on BOOK Knowledge, whereby those with Acute Pain had lower scores across time, regardless of intervention, relative to those with Chronic Pain and Illicit Opioid Use. Compared to baseline, all three groups reported fewer instances of using opioids alone or concurrently with alcohol at the 30-day follow-up.

Conclusions: A web-based intervention increased opioid overdose knowledge and decreased overdose risk behavior immediately and at a one-month follow-up, suggesting that this brief, practical, and scalable program could have utility in several populations who are at-risk of opioid overdose.

Keywords: Acute pain; Analgesic; Chronic pain; Crowdsourcing; Drug overdose; Opioid; Web-based intervention.

Figure 1.

Number of participants within each Pain Group and Intervention.

Figure 2.

Brief Opioid Overdose Knowledge (BOOK) Total Scores (Mean ± Standard Error; total possible range 0–12) Across Time Points among Individuals with Prescription Opioid Use and Acute Pain (A), Prescription Opioid Use and Chronic Pain (B), and Illicit Opioid Use with No Pain (C).

Figure 3.

Percentage of participants in each Pain Group reporting risky opioid use behaviors in the 30 days prior to the intervention (Baseline) and in the 30 days after the intervention (30-day follow-up). Asterisks (*) indicate a significant change in the percentage of participants reporting risky opioid use behavior between the two time points, p < .05.