A multifaceted intervention to improve patient knowledge and safe use of opioids: Results of the ED EMC2 randomized controlled trial
Academic Emergency Medicine Dec 12, 2019
McCarthy DM, Curtis LM, Courtney DM, et al. - Researchers examined how an Electronic Medication Complete Communication (EMC2) Opioid Strategy influences patients’ safe use of opioids and knowledge about opioids. They undertook a three-arm prospective, randomized controlled pragmatic trial with randomization occurring at the physician level. At an urban academic emergency department (ED), consecutive discharged patients (> 88,000 visits) with new hydrocodone-acetaminophen prescriptions received one of three care pathways: 1) usual care, 2) EMC2 intervention, or 3) EMC2 + short message service (SMS) text messaging. In the ED EMC2 intervention, two patient-facing educational tools (MedSheet, literacy-appropriate prescription wording [Take-Wait-Stop]) and three provider-facing reminders to counsel (directed to ED physician, dispensing pharmacist, follow-up physician) were included. One text message/day for 1 week was provided additionally to patients in the EMC2 + SMS arm. They enrolled 652 patients; of these, 343 completed follow-up (57% women; mean ± SD age = 42 ± 14.0 years). Outcomes revealed improvement in demonstrated safe dosing in correlation to receiving the EMC2 tools, however, these benefits did not translate into actual use based on medication dairies. No improvement in patient knowledge was evident in relation to providing text-messaging intervention.
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