Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan.
Pain Med. 2021 Apr 20;22(4):961-969. doi: 10.1093/pm/pnaa431.
To determine how passively providing informational handouts and/or drug disposal kits affects rates of leftover prescription opioid disposal.
A multi-arm parallel-group randomized controlled trial with masked outcome assessment and computer-guided randomization.
Johns Hopkins Health System outpatient pharmacies.
Individuals who filled ≥1 short-term prescription for an immediate-release opioid for themselves or a family member.
In June 2019, 499 individuals were randomized to receive an informational handout detailing U.S. Food and Drug Administration-recommended ways to properly dispose of leftover opioids (n = 188), the informational handout and a drug disposal kit with instructions on its use (n = 170), or no intervention (n = 141) at prescription pickup. Subjects were subsequently contacted by telephone, and outcomes were assessed by a standardized survey. The primary outcome was the use of a safe opioid disposal method.
By 6 weeks after prescription pickup, 227 eligible individuals reported they had stopped taking prescription opioids to treat pain and had leftover medication. No difference in safe disposal was observed between the non-intervention group (10% [6/63]) and the group that received disposal kits (14% [10/73]) (risk ratio = 1.44; 95% confidence interval: 0.55 to 3.74) or the group that received a fact sheet (11% [10/91]) (risk ratio = 1.15; 95% confidence interval: 0.44 to 3.01).
These findings suggest that passive provision of a drug disposal kit at prescription pickup did not increase rates of leftover opioid disposal when compared with provision of a fact sheet alone or no intervention. Active interventions may deserve further investigation.
确定被动提供信息传单和/或药物处置包如何影响剩余处方阿片类药物处置率。
一项多臂平行组随机对照试验，具有盲法结局评估和计算机引导的随机分组。
约翰霍普金斯卫生系统门诊药房。
为自己或家庭成员填写≥1 份短期即用阿片类药物处方的个人。
2019 年 6 月，499 名参与者被随机分配接受信息传单，详细说明美国食品和药物管理局推荐的正确处理剩余阿片类药物的方法（n=188），信息传单和药物处置包，其中包含有关其使用方法的说明（n=170），或在取药时不进行干预（n=141）。随后通过电话联系受试者，并通过标准化调查评估结果。主要结局是使用安全的阿片类药物处置方法。
在取药后 6 周，227 名符合条件的参与者报告他们已停止服用处方阿片类药物治疗疼痛，并留下了剩余的药物。在未干预组（10%[6/63]）和接受处置包组（14%[10/73]）（风险比=1.44；95%置信区间：0.55 至 3.74）或接受情况说明书组（11%[10/91]）（风险比=1.15；95%置信区间：0.44 至 3.01）之间，安全处置无差异。
这些发现表明，与仅提供情况说明书或不干预相比，在取药时被动提供药物处置包并未增加剩余阿片类药物处置率。主动干预可能值得进一步研究。
