An online tool that asks patients about their possible risks for prescription opioid misuse or abuse could help patients make more informed choices, including possibly opting for non-opioid over opioid medications, according to a new pilot study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

The paper titled, “My Healthy Choices: Innovative M-health Intervention Addressing Opioid Misuse, Storage, and Disposal,” was presented at the American Public Health Association meeting.

The tool was developed by a software developer contracted by Bloomberg School researchers. To help build the tool, the researchers conducted informational interviews with 17 patients, 11 emergency room clinicians and six experts from national organizations about pain management and emergency medicine.

For the pilot study, the research team asked 124 emergency-room patients to complete an online questionnaire, part of an iPad-based-tool called MyHealthyChoices that assesses patients’ risks for opioid use and misuse. The pilot study showed that the tool was well received by patients and easy to integrate into busy emergency-room settings.

“Patient decision-making is an under-explored area in the search to combat the opioid epidemic,” said Eileen McDonald, MS, senior scientist at the Johns Hopkins Center for Injury Research and Policy at the Bloomberg School and study team member. “A tool like this could empower patients with timely education about pain treatment options as well as personalized information about their own and their family’s risks for opioid misuse or abuse.”

The tool includes information that explains pain medication options (both opioid and non-opioid) to patients, and assesses and explains their personal and family risk factors related to taking opioids. The tool also helps the patient understand priorities related to treating his or her pain by asking the patient to rank a series of comparisons pain relief versus risk avoidance. Based on these answers, the tool then produces a tailored report that documents the patient’s priorities for pain treatment options and any personal or family risks relevant to opioids. Patients were encouraged to share the report’s findings with the treating clinician.

Compared to a control group of patients, those who used the MyHealthChoices tool had increases in knowledge about opioids and significant reductions in decisional conflict, that is, anxiety about how their pain would be treated, based on the tool’s scoring system. The tool did not influence patients’ reports of patient/provider decision-making about pain medication nor did it significantly reduce prescribing. This is likely because this study focused on patients rather than doctors, and patients were not reqired to share their assessment results with their doctor.

Next, McDonald said, is enhancing the tool with a reporting feature for the prescribing physician. This could promote discussion about which pain medication might best suit a patient. “Improving patient knowledge and reducing their decisional conflict about pain treatment options is a step in the right direction for improving patient education about treating their acute pain,” said McDonald.

Other components of the tool, including educating patients about safe use, storage and disposal, were examined in this pilot study and will be reported in future work.