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Pediatrics. 2020 Jan;145(1). pii: e20191431. doi: 10.1542/peds.2019-1431.

Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial.

Author information

1
Departments of Anesthesiology, terriv@umich.edu.
2
Health Behaviors and Biological Science, School of Nursing, and.
3
Orthopedic Surgery.
4
Departments of Anesthesiology.
5
Psychiatry.
6
Surgery.
7
Division of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
8
Internal Medicine, and.

Abstract

OBJECTIVES:

Leftover prescription opioids pose risks to children and adolescents, yet many parents keep these medications in the home. Our objective in this study was to determine if providing a behavioral disposal method (ie, Nudge) with or without a Scenario-Tailored Opioid Messaging Program (STOMP) (risk-enhancement education) improves parents' opioid-disposal behavior after their children's use.

METHODS:

Parents whose children were prescribed a short course of opioids were recruited and randomly assigned to the Nudge or control groups with or without STOMP. Parents completed surveys at baseline and 7 and 14 days. Main outcomes were (1) prompt disposal (ie, immediate disposal of leftovers after use) and (2) planned retention (intention to keep leftovers).

RESULTS:

There were 517 parents who took part, and 93% had leftovers after use. Prompt disposal behavior was higher for parents who received both the STOMP and Nudge interventions (38.5%), Nudge alone (33.3%), or STOMP alone (31%) compared with controls (19.2%; P ≤ .02). Furthermore, the STOMP intervention independently decreased planned retention rates (5.6% vs 12.5% no STOMP; adjusted odds ratio [aOR] 0.40 [95% confidence interval (CI) 0.19-0.85]). Higher risk perception lowered the odds of planned retention (aOR 0.87 [95% CI 0.79-0.96]), whereas parental past opioid misuse increased those odds (aOR 4.44 [95% CI 1.67-11.79]).

CONCLUSIONS:

Providing a disposal method nudged parents to dispose of their children's leftover opioids promptly after use, whereas STOMP boosted prompt disposal and reduced planned retention. Such strategies can reduce the presence of risky leftover medications in the home and decrease the risks posed to children and adolescents.

PMID:
31871245
PMCID:
PMC6939843
[Available on 2021-01-01]
DOI:
10.1542/peds.2019-1431

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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