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Randomized Controlled Trial
. 2022 Oct;63(4):564-573.
doi: 10.1016/j.amepre.2022.04.035. Epub 2022 Jul 28.

A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT

Terri Voepel-Lewis  1 , Carol J Boyd  2 , Alan R Tait  3 , Sean Esteban McCabe  4 , Brian J Zikmund-Fisher  5
Affiliations
Randomized Controlled Trial

A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT

Terri Voepel-Lewis et al. Am J Prev Med. 2022 Oct.

Abstract

Introduction: Retaining leftover prescription opioids poses the risks of diversion, misuse, overdose, and death for youth and other family members. This study examined whether a new educational program would enhance risk perceptions and disposal intentions among parents and decrease their retention of leftover prescription opioids.

Study design: This study is an RCT (NCT03287622).

Setting/participants: A total of 648 parents whose children were prescribed opioid analgesics were recruited from a Midwestern, academic pediatric hospital between 2017 and 2019. Parents were randomized to receive routine information (control) with or without Scenario-Tailored Opioid Messaging Program intervention.

Intervention: The intervention provided opioid risk and mitigation advice using interactive decisional feedback.

Main outcome measures: The main outcome measures were parents' perceptions of the riskiness of keeping/sharing opioids and child misuse measured at baseline, Days 3 and 14, their intention to dispose of leftover opioids, and their final retention decisions after the child's use (at or around Day 14).

Results: Perceived riskiness of child misuse and keeping/sharing opioids increased from baseline through Day 14 only for parents in the intervention group (p≤0.006). However, there were no significant differences in risk perceptions between groups and no intervention effect on disposal intentions at either follow-up. Despite these findings, the intervention reduced the likelihood of parents' opioid retention when adjusted for important parent and child covariates (AOR=0.48; 95% CI=0.25, 0.93; p=0.028). Parents who reported past opioid misuse also showed higher retention behavior (AOR=4.78; 95% CI=2.05, 11.10; p<0.001).

Conclusions: A scenario-specific educational intervention emphasizing the potential risks that leftover opioids pose to children and that provided risk mitigation advice decreased parents' retention of their child's leftover opioid medication. Removing leftover prescription drugs from homes with children may be an important step to reducing diversion, accidental poisoning, and misuse among youth.

Trial registration: This study is registered at www.

Clinicaltrials: gov NCT03287622.

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Figures

Figure 1.
Figure 1.
CONSORT diagram depicting study enrollment and analytical sample. *p<0.01 vs control. LTFU, loss to follow-up; STOMP, Scenario-Tailored Opioid Messaging Program.
See this image and copyright information in PMC

References

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