Waddell Alex, Watterson Jessica L, Basur Dhruv, Prawira Christopher Owen, Picco Louisa, Lam Tina, Olivier Patrick, Seguin Joshua Paolo, Kay Liam, Nielsen Suzanne
Action Lab, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia.
Deakin University School of Public Health and Social Development, Deakin University, Melbourne, VIC, Australia.
Front Digit Health. 2025 Jul 11;7:1600836. doi: 10.3389/fdgth.2025.1600836. eCollection 2025.
INTRODUCTION: Australia has one of the highest rates of opioid prescribing and prescription opioid-related harm in the world. Although effective for pain relief, the use of prescription opioids is a leading cause of preventable morbidity and mortality. Barriers exist for consumers identifying their own risk factors, accessing naloxone (opioid overdose antidote) and overdose prevention education. This study aimed to co-design a digital Opioid Safety Toolkit for national dissemination through pharmacies to encourage three consumer opioid safety behaviours: (1) uptake of naloxone, (2) creating a safety plan, and (3) discussing their use of opioids, including any concerns with their healthcare professional. METHODS: The digital Toolkit was co-designed and developed using a novel approach to digital health intervention design combining the Theoretical Domains Framework (TDF) and Double-Diamond design process. Co-design involved a series of seven iterative workshops with consumers (4) and professionals (3). Workshops focused on identifying factors influencing opioid safety behaviours, exploring design preferences, sense-checking, and ideation of the user flow. User testing was conducted with the penultimate version of the Toolkit. RESULTS: 13 consumers with lived experience of prescription opioid use and 14 professionals including prescribers, pharmacists, pain specialists, researchers and consumer advocates participated in up to three separate workshops. 15 consumers participated in user testing interviews. Analysis of workshops identified factors promoting safety behaviours including increased public awareness of naloxone, understanding personal risk (TDF domain of Knowledge); healthcare professional's role in education and consumers' experience of stigma (Social/professional role and identity); use of conversational aids to scaffold conversations, material resources and data ownership (Environment, context and resources). User testing elicited feedback pertaining to the information and resources on the website and the overall user interface and experience. DISCUSSION: The Toolkit was co-designed with consumers and professionals to facilitate opioid safety behaviours. The Toolkit includes evidence-based information, tools for risk assessment and screening, opioid use monitoring, conversation aids, and a safety plan. The Toolkit is being disseminated nationally through Australian pharmacies following a randomized controlled trial that demonstrated the Toolkit promotes safety behaviours, is easy to use and acceptable to those with lived experience of prescription opioid use and professionals.
引言:澳大利亚是世界上阿片类药物处方率和与处方阿片类药物相关伤害率最高的国家之一。尽管处方阿片类药物对缓解疼痛有效,但它是可预防的发病和死亡的主要原因。消费者在识别自身风险因素、获取纳洛酮(阿片类药物过量解毒剂)和过量预防教育方面存在障碍。本研究旨在共同设计一个数字化阿片类药物安全工具包,通过药房在全国范围内传播,以鼓励消费者采取三种阿片类药物安全行为:(1)获取纳洛酮,(2)制定安全计划,以及(3)与他们的医疗保健专业人员讨论其阿片类药物的使用情况,包括任何担忧。 方法:数字化工具包采用一种新颖的数字健康干预设计方法进行共同设计和开发,该方法结合了理论领域框架(TDF)和双钻石设计流程。共同设计包括与消费者(4名)和专业人员(3名)进行的一系列七个迭代研讨会。研讨会重点在于识别影响阿片类药物安全行为的因素、探索设计偏好、进行合理性检查以及构思用户流程。使用工具包的倒数第二个版本进行了用户测试。 结果:13名有处方阿片类药物使用经历的消费者和14名专业人员(包括开处方者、药剂师、疼痛专家、研究人员和消费者权益倡导者)参加了多达三个不同的研讨会。15名消费者参与了用户测试访谈。对研讨会的分析确定了促进安全行为的因素,包括公众对纳洛酮的认识提高、对个人风险的理解(TDF知识领域);医疗保健专业人员在教育中的作用以及消费者的耻辱感经历(社会/专业角色和身份);使用对话辅助工具来构建对话、物质资源和数据所有权(环境、背景和资源)。用户测试收集了有关网站上的信息和资源以及整体用户界面和体验的反馈。 讨论:该工具包是与消费者和专业人员共同设计的,以促进阿片类药物安全行为。该工具包包括基于证据的信息、风险评估和筛查工具、阿片类药物使用监测、对话辅助工具以及安全计划。在一项随机对照试验表明该工具包能促进安全行为、易于使用且为有处方阿片类药物使用经历的人和专业人员所接受之后,该工具包正在通过澳大利亚的药房在全国范围内传播。
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