DESCRIPTION (provided by applicant): The overall objective of this study is to leverage the electronic health record to implement a multifaceted strategy to better educate emergency department patients about medication risks and safe use for opioid pain relievers. Failure to take opioids safely can result in not only side effects, but also respiratory depression and death; deaths from opioid-related overdoses have tripled since the 1990s. One of every six patients discharged from the emergency department (ED) receives a prescription for an opioid. Unfortunately, recent studies indicate that emergency department discharge processes are inadequate, and patients often leave without the knowledge necessary to properly care for themselves. This lack of knowledge is potentially dangerous for patients receiving opioids, who may not know how to take their medication safely or be aware of its potential hazards. This project will leverage the strengths of a multidisciplinary research team and combine several health-literacy appropriate educational strategies to create an EHR-based medication complete communication (EMC2) strategy to promote safe use of opioid pain relievers. The EMC2 strategy will impart risk information to patients at multiple points in time and using multiple modalities. We will conduct a three-arm trial at an urban academic emergency department to evaluate the EMC2 and EMC2+SMS text message reminder strategies compared to usual care (N=816 patients; 272 patients per study arm). The primary outcome of interest will be a decrease in medication errors as measured by demonstrated safe medication use. Other safety outcomes will also be examined and patient knowledge will be measured. Additionally, we will assess the fidelity and economic impact of the interventions to identify any necessary modifications to guide future dissemination efforts.

PUBLIC HEALTH RELEVANCE: We will conduct a clinical trial at an urban academic emergency to evaluate an EHR-based, medication complete communication (EMC2) strategy to promote safe use of opioid pain relievers. We will also assess the fidelity and economic impact of the interventions.