The Life STORRIED Study
Opioid Dependence, Communication, Risk Behavior
About this trial
This is an interventional prevention trial for Opioid Dependence
Eligibility Criteria
Inclusion Criteria:
- Age 18 years to 70 years old
- Experiencing back pain or renal colic
- Text messaging and internet access including email capabilities or access to a smartphone
- Anticipated discharge within 24 hours
Exclusion Criteria:
- Patients who take opioids for chronic pain or cancer treatments
- Patients who have taken opioids in the past month with the exception of patients who have taken opioids in the previous 48 hours before arriving at the ED for their presenting condition based on provider assessment
- Patients who are pregnant, in police custody, intoxicated, cognitively impaired, or otherwise unable to fully consent and participate
- Patients who are hemodynamically compromised, in respiratory distress, or in severe emotional or physical distress.
- Patients older than 70 or younger than 18
- Patients who will be admitted to hospital or deemed to have a critical illness based on provider assessment
- Patients who are cognitively impaired
- Patients who are suicidal or homicidal ideation by chart review and clinician assessment.
- Patients with evidence of aberrant behavior based on clinical assessment
- Patients who do not have a phone, text messaging OR email address
- Patients under police arrest at ED visit
- Patients who are non-English or Spanish speaking
- Patients previously enrolled
- Patient with any current contraindications for NSAIDs or opioid medications including allergies, chronic kidney disease (GFR60, if measured)
Sites / Locations
- University of Alabama- Birmingham
- Mayo Clinic
- Northwell Health
- University of Pennsylvania
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Active Comparator
Active Comparator
Generalized Risk Communication (GRC)
Probabilistic Risk Communication (PRT)
Narrative Enhanced Risk Tool (NERT)
Generalized Risk Communication (GRC): Participants in this arm will receive standard discharge instructions similar to instructions they would receive during usual care. This arm represents a standardized way of communicating post-discharge risk-benefit information about treatment options for patients with back pain and renal colic. The GRC, includes a standardized discharge information sheet about the clinical condition of interest and a written overview of population based evidence describing comparative benefits and side effects of alternative classes of medication acute pain.
Probabilistic Risk Communication (PRT): The probabilistic risk communication tool (PRT) is a visual tool that communicates risk using the previously validated Opioid Risk Tool (ORT). The ORT is designed to assess risk of opioid dependency for patients for whom an opioid pain relief prescription is being considered in outpatient settings. Patients in this arm will be given an iPad which will prompt them to take a short survey that automatically communicates their risk score. After which the iPad will show them a color coded visual thermometer that informs them of their risk of having issues related to opioids.
Narrative Enhanced Risk Tool (NERT): Participants assigned to this arm will receive the PRT described above but will also be instructed to watch one or more narrative videos. This video intervention will include a brief narrative video of an individuals' cautionary tale related to prolonged opioid use. Narrative videos are developed from actual patient stories - put into a in a structured format of ~ 2-minute length and recorded.