Distribution of Medication Disposal Packets - Acute Opioid Prescribing

University of Pennsylvania

Status: Completed

Conditions: Orthopedic Surgery; Surgery; Neurosurgery; Opioid Use; Opioid Misuse

Treatments: Other: Medication Disposal Packet

Study type: Interventional

Funder types: Other

Identifiers

NCT05169281

827461_1

Details and patient eligibility

About

Many prescription opioids following surgery are left unused and are at risk of being misused or diverted. Encouraging proper disposal is important, yet motivating this behavior remains challenging as patients must understand the risks of opioids, the benefits of disposal, and identify opportunities and places to dispose of them safely. Alternative disposal techniques can improve disposal rates but may be lost or forgotten. Applying behavioral economics techniques may lower the barriers and promote disposal. The objective is to test the effect of a specifically timed, mailed, at-home kit on disposal rates following surgery.

Full description

A pragmatic, cluster-randomized quality improvement study embedded in an existing automated, post-operative text messaging program to capture patient-reported outcomes (e.g., pain score, opioid use, ability to manage pain) and disposal as part of usual care. It was approved by the University of Pennsylvania Institutional Review Board with a waiver of informed consent.

All patients, 18 years or older, undergoing an orthopedic or urologic procedure and prescribed an opioid were approached and consented via text messaging. Patients without access to a text message capable device or non-English speaking were excluded. Participants were block randomized to usual care or a mailed at-home disposal packet. Usual care consisted of a text message hyperlink to nearby disposal locations. Intervention participants were mailed an at-home disposal packet timed to arrive between post-operative days four and seven based on prior data collection on reported use. The disposal packet (DisposeRx Inc.) contains a powder that sequesters unused opioids in a polymer gel. Patients self-reported disposal via the automated system.

Enrollment: 657 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults 18 or older
• Undergoing an orthopedic or urologic procedure
• Prescribed an opioid
• SMS capable mobile device
• English speaking

Exclusion criteria

• Under 18
• Does not own a text message capable mobile phone
• non-English speaking

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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657 participants in 2 patient groups

Control

No Intervention group

Description:

Usual care consisted of a text message hyperlink to nearby disposal locations.

Intervention

Experimental group

Description:

Intervention participants were mailed an at-home disposal packet timed to arrive between post-operative days four and seven based on prior data collection on reported use.

Treatment:

Other: Medication Disposal Packet