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Feng et al, 2021, USA |
Assess narrative based video’s effective-ness in increasing patients’ self-efficacy for tapering and intention to taper compared to an informational pamphlet on opioid tapering. |
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Participants who
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experienced pain most or all the time during the past 30 days, and
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was suffering from pain for 6 months or longer, and
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were prescribed opioids and taking opioids at least once a week, and
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did not report a reduction in prescribed opioid dose during the past year.
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N = 239.
n = 128. A 13 min long narrative-based patient education video, consisting of small segments (30 s long each).
n = 111. A 2 page long opioid tapering pamphlet, containing 565 words. |
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Outcome 1––3: measured as an average of responses to 3 items measured on a 5-point Likert-scale.
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Group differences analyzed using separate linear regression analysis.
Participants’ demographic characteristics and pre-intervention measures (pain intensity, pain related interference with life, perceptions of opioid effectiveness, concerns about opioids, or their preintervention tapering intention) are included as covariates in primary analyses. |
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Sig. higher perceptions of tapering effectiveness in the video group (mean = 4.06) than the pamphlet group (mean = 3.67), adjusted mean difference = 0.34, 95 %CI 0.13 – 0.54, P < 0.001.
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Sig higher perceptions of tapering self-efficacy in the video group (mean = 3.97) than the pamphlet group (mean = 3.60), adjusted mean difference = 0.32, 95 %CI 0.09 – 0.55, P < 0.001.
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No sig. difference in tapering intention between intervention groups.
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Bergeria et al, 2019, USA |
Compare opioid overdose knowledge following a presentation or a presentation + mastery intervention and assessing 30-day knowledge retention. |
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Pre-test/ post-test, 30-day follow up.
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Online recruitment through MTurk
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Intervention delivered through the online survey manager Qualtrics.
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Participants were:
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≥18 years old, and
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Current opioid users, and
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Resided in the United States, and
≥80 % approval rate from completion of HIT.
Allocated to risk group:
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Acute pain.
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Chronic pain.
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No pain (illicit opioid use).
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N = 119
n = 61. 25 educational slides with text, pictures, and/or videos about general opioid knowledge, opioid OD knowledge, and opioid OD response knowledge.
n = 58. Same 25 educational slides but with embedded questions with corrective feedbacks. Achievement of ≥ 80 % accuracy to the questions were required to advance the intervention. If this was not achieved, participants had another opportunity to answer questions correctly. After 3 failures participants were automatically advanced to the next module.
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OD knowledge/BOOK scores (measured pre- and post-intervention, and at 30-day follow-up):
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1.
General opioid knowledge.
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2.
Opioid OD knowledge.
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3.
Opioid OD response knowledge.
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4.
The BOOK total score.
Past 30-day risk behavior, measured pre-intervention and at 30-day follow up:
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5.
Use of prescription opioids or heroin alone.
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6.
Use of pain pills or heroin parallel with alcohol.
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7.
Use of non-prescribed methadone
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Outcome 1–3: Each outcome was measured as the sum of correct responses to 4 items (range 0–4) with response options “True”, “False”, or “I Don't Know”.
Outcome 4: Summation of the 3 subscores from outcome 1–3 (range: 0–12).
Outcome 5–7: Measured dichotomously (yes/no).
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BOOK scores analyzed using RM ANOVA for:
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A.
Main effect and interactions of intervention type on the 4 BOOK-scores across time.
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B.
Main effects and interactions of each pain group, intervention type, and timepoint on the 4 BOOK scores.
Bonferroni corrected post-hoc analyses were used.
Past 30-day risk behaviors (chi-squared tests):
Intervention type as a function of time.
Pain groups as a function of time.
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A.
BOOK-scores across time:
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Sig. increase from pre- to post-intervention and 30-day follow-up.
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1.
General opioid knowledge subscores, p < 0.001,
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2.
Opioid OD knowledge subscores, p < 0.001
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3.
Opioid OD response knowledge subscores, p < 0.001.
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4.
BOOK total scores, p < 0.001.
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Small sig. decrease in outcome 1, 2, and 4 between post-intervention and 30-day follow-up, p's < 0.05.
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No sig. effect on BOOK scores (outcome 1–4) between intervention and comparator group, p's > 0.05.
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B.
BOOK-scores across pain groups:
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1.
Acute pain participants had sig. lower general opioid knowledge scores than the chronic and no pain groups, p < 0.01,
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2.
Acute pain participants had sig. lower opioid OD knowledge scores than the chronic and no pain groups, p < 0.05,
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3.
Acute pain participants had sig. lower opioid OD response knowledge scores relative to the chronic pain group, p < 0.05.
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4.
Acute pain participants had sig. lower BOOK total scores compared to the chronic pain participants across all time, p = 0.001.
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No Intervention x Pain group interactions were observed for the BOOK total or sub scores (p's > 0.05).
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C.
Changes in risky opioid use across time
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5.
Sig. fewer participants used opioids alone at follow-up (37.8 %) compared to pre-intervention (51.3 %), p = 0.03.
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6.
Sig. fewer participants reported using alcohol concurrently with opioids at follow-up (20 %) compared to pre-intervention (35 %), p = 0.01.
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These results did not vary as a function of intervention, p = 0.24.
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7.
No sig. change in the frequency of individuals who used non-prescribed methadone at follow-up (5 %) compared pre-intervention (6 %), p = 0.78.
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D.
Changes in risky opioid use across pain groups at follow-up.
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Individuals with acute pain were less likely to use alcohol with opioids when compared to individuals with no pain and illicit opioid use (27.6 % v. 39.0 %) but were more likely to use alcohol with opioids compared to individuals with chronic pain (27.6 % v. 17.3 %), p = 0.005).
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Young et al, 2018, USA |
Assess the feasibility of a 12-week HOPE social media-based support intervention to reduce risk of opioid misuse and OD among patients on chronic opioid therapy for chronic non-cancer pain. |
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Pre-test/ post-test (12-week follow-up).
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Online recruitment and enrolment through the UCLA health system.
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Intervention delivered through Facebook.
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Participants were:
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UCLA health system patients, and
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receiving chronic opioid therapy for non-cancer pain, and
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≥18 years old, and
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at-risk for prescription opioid misuse/OD, and
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had a COMM, 17 items questionnaire score >= 9, and/or self-reported concomitant use of opioids and benzodiazepines.
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N = 51
n = 25. 12-week enrollment into a closed secret Facebook group moderated by 8 peer leaders/role models, to create a supportive and engaging community.
n = 26. 12-week enrollment into a closed Facebook community group without peer leaders.
After enrollment, participation in the online communities was voluntary. |
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1.
Number of engaged participants.
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2.
Engagement score among the engaged participants, defined as the sum of posts, comments, and reactions.
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3.
Category of topics of posts and comments.
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Outcome 1: Measured as those who posted, commented, or reacted at least once over the 12-week period.
Outcome 2: Measured as the sum of posts, comments, and reactions.
Outcome 3: Hand-coded into following topics: Physical health status, mental health status, pain, non-medication treatment, medication treatment, substance use disorder, coping, social support, and other topics. |
Group differences analyzed using:
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A.
chi-square test of independence for number of engaged participants.
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B.
Two-sample t test for engagement score.
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C.
Descriptive frequencies of post topics.
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A.
For each study period (week 1–4, 4–8, 8–12), a higher number of participants in the peer leaders’ group were engaged compared to those in the comparator group. This difference was only sig. during the first study period (weeks 1–4), p = 0.05.
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B.
Participants in the peer leaders’ group had a sig. higher engagement score across all time periods, compared to those in the comparator group, p < 0.001. The average score for the 12 weeks were 1.25 vs. 8.20, p < 0.001.
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Over the 12-week period, 19 out of 26 participants (73 %) in the peer leader group provided a total of 411 posts or comments. In contrast, 13 out of 25 participants (52 %) in the comparator group provided a total of 45 posts or comments.
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C.
The peer leaders group posted about the following topics: Coping (33 %), physical health status (32 %), medication treatment (27 %), pain (26 %), nonmedication treatment (24 %), mental health status (21 %), and social support 19 %).
The group without leaders primarily focused on their personal clinical experiences. Out of the 45 posts and comments posted by the group, > 50 % were attributed to the following topics: Physical health status (56 %) and medication treatment (53 %).
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Young et al, 2020, USA |
Assess the feasibility and preliminary efficacy of using a HOPE Facebook community, compared to a comparator Facebook community, with a special focus on whether the intervention translates to reduced anxiety and opioid misuse among non-cancer opioid patients. |
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Pre-test/ post-test (12-week follow-up).
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Online recruitment and enrolment through the UCLA health system.
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Intervention delivered through Facebook.
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Participants were:
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UCLA health system patients, and
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Prescribed opioids for non-cancer chronic pain between 3–12 months ago, and
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≥18 years old, and
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at-risk for prescription opioid misuse/OD, and
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receiving a COMM, 17 items questionnaire score >= 9, and/or self-reported concomitant use of opioids and benzodiazepines
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N = 38 with complete baseline and follow-up assessment.
n = 20. 12-week enrollment into a closed secret Facebook group moderated by peer role models. 3 peer leaders attended the group, to stimulate conversations about pain and personal experiences and not clinical recommendations.
n = 18. 12-week enrollment into a closed Facebook community group without peer leaders.
After enrollment participation in the online communities was voluntary. |
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Outcome 1: Coded into following topics: pain, prescription opioid use, coping strategies, places to seek help, alternative therapies for pain, and illegal substances to help address pain.
Outcome 2: Measured as the sum of scores on a 17-items questionnaire where each item is rated on a 5-point scale ranging from 0 to 4. The total COMM score range from 0 to 36 and a score >= 9 is the cut-off point for opioid misuse.
Outcome 3: Measured as the sum of scores to 7 items rated on a 4-point scale rating from 0 to 3. The total GAD-7 score range from 0 to 21. |
Group differences analyzed using:
|
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A.
Post intervention (12 weeks) participants in the peer leader group used social media to discuss their pain, prescription opioid use, coping strategies, places to seek help, and alternative therapies for pain sig. more frequent compared to the community group without peer leaders, p ≤ 0.02. No sig. difference between groups in discussions about illegal substances to help address pain, p = 0.11.
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B.
The peer leader intervention group showed:
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Sig. reduction in GAD-7 score from pre- to post intervention, p = 0.04, translating a reduction from moderate to mild anxiety.
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Sig. reduction in COMM scores from pre- to post intervention, p = 0.03.
The community group without peer leaders showed:
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no sig. changes in GAD-7 from pre- to post intervention, p = 0.58.
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Sig. reduction in COMM scores, p = 0.02.
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