Young Sean D, Lee Sung-Jae, Perez Hendry, Gill Navkiran, Gelberg Lillian, Heinzerling Keith
Department of Informatics, School of Information and Computer Sciences, University of California, Irvine, CA, USA.
Department of Emergency Medicine, School of Medicine, University of California, Irvine, CA, USA.
Heliyon. 2020 Mar 6;6(3):e03471. doi: 10.1016/j.heliyon.2020.e03471. eCollection 2020 Mar.
Interventions are urgently needed to reduce prescription opioid misuse risk factors, including anxiety and concomitant use of sedatives. However, only a limited number of randomized controlled opioid intervention trials have been conducted. We sought to determine whether an online behavior change/support community, compared to a control Facebook group, could reduce anxiety and opioid misuse among chronic pain patients. 51 high-risk non-cancer chronic pain patients were randomly assigned to either a Harnessing Online Peer Education (HOPE) peer-led online behavior change intervention or a control group (no peer leaders) on Facebook for 12 weeks. Inclusion criteria were: 18 years or older, a UCLA Health System patient, prescribed an opioid for non-cancer chronic pain between 3 and 12 months ago, and a score of ≥9 on the Current Opioid Misuse Measure (COMM) and/or concomitant use of benzodiazepines. Participation in the online community was voluntary. Patients completed baseline and follow-up assessments on Generalized Anxiety Disorder screener (GAD-7), COMM, and frequency of social media discussions about pain and opioid use. Compared to control group participants, intervention participants showed a baseline-to-follow-up decrease in anxiety, and more frequently used social media to discuss pain, prescription opioid use, coping strategies, places to seek help, and alternative therapies for pain. Both groups showed a baseline to follow-up decrease in COMM score. Preliminary results support the use an online community interventions as a low-cost tool to decrease risk for prescription opioid misuse and its complications.
迫切需要采取干预措施来降低处方阿片类药物滥用的风险因素，包括焦虑和同时使用镇静剂。然而，仅进行了有限数量的随机对照阿片类药物干预试验。我们试图确定，与一个对照脸书群组相比，一个在线行为改变/支持社区是否能够减少慢性疼痛患者的焦虑和阿片类药物滥用情况。51名高风险非癌症慢性疼痛患者被随机分配至一个由同伴主导的在线行为改变干预措施“利用在线同伴教育（HOPE）”组或脸书上的一个对照组（无同伴领导者），为期12周。纳入标准为：年龄18岁或以上，是加州大学洛杉矶分校医疗系统的患者，在3至12个月前因非癌症慢性疼痛开具了阿片类药物处方，且在当前阿片类药物滥用测量量表（COMM）上得分≥9分和/或同时使用苯二氮䓬类药物。参与在线社区是自愿的。患者完成了关于广泛性焦虑障碍筛查量表（GAD - 7）、COMM以及关于疼痛和阿片类药物使用的社交媒体讨论频率的基线和随访评估。与对照组参与者相比，干预组参与者的焦虑从基线到随访有所下降，并且更频繁地使用社交媒体来讨论疼痛、处方阿片类药物使用、应对策略、寻求帮助的地点以及疼痛的替代疗法。两组的COMM评分从基线到随访均有所下降。初步结果支持将在线社区干预作为一种低成本工具来降低处方阿片类药物滥用及其并发症的风险。
