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Experiencing the risk of overutilizing opioids among patients with chronic noncancer pain in ambulatory care (ERONA): an exploratory, randomized controlled trial
- Odette Wegwarth
- Claudia Spies
- Erika Schulte
- Joerg J Meerpohl
- Christine Schmucker
- Edris Nury
- Dirk Brockmann
- Norbert Donner-Banzhoff
- Stefan Wind
- Eva Goebel
- Wolf Dieter Ludwig
- Ralph Hertwig
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Category: Project
Description: Introduction. The US opioid crisis and increasing prescription rates in Europe suggest inappropriate risk perceptions and behaviors of people who prescribe, take, or advise on opioids: physicians, patients, and pharmacists. Findings from cognitive and decision science in areas other than drug safety suggest that people’s risk perception and behavior can differ depending on whether they learned about a risk through personal experience or description. ERONA is the first-ever conducted trial that aims at investigating the effects of these two modes of learning on individuals’ risk perception and behavior in the long-term administration of WHO-III opioids in chronic noncancer pain. Methods and analysis. ERONA—an exploratory, randomized controlled online survey intervention trial with two parallel arms—will examine the opioid-associated risk perception and behavior of four groups involved in the long-term administration of WHO-III opioids: (1) family physicians, (2) physicians specialized in pain therapy, (3) patients with chronic (≥3 months) noncancer pain, and (4) pharmacists who regularly dispense narcotic substances. Participants will be randomly assigned to one of two online risk education interventions, description-based or experience-based. Both interventions will present the best medical evidence available. Participants will be queried at baseline and after intervention on their risk perception of opioids’ benefit–harm ratio, their medical risk literacy, and their current/intended risk behavior (in terms of prescribing, taking, or counselling, depending on study group). A follow-up will occur after 9 months, when participants will be queried on their actual risk behavior. The study was developed by the authors and will be conducted by the market research institution IPSOS Health. Ethics and dissemination. The study was approved by the Institutional Review Board of the Max Planck Institute for Human Development. Results will be disseminated through peer-reviewed journals, conference presentations, and social media.