Gwihyun Kim, Hyekyung Woo, Young-A Ji
Factors Affecting Abdominal Obesity: Analyzing National Data
Healthcare (Basel, Switzerland)
directtoconsumer education reduces chronic sedative use effectiveness approach prescription opioids among patients chronic noncancer pain remains untested evaluate effectiveness governmentled educational information brochure mailed communitydwelling longterm opioid consumers reduce prescription opioid use compared usual care cluster randomized clinical trial conducted july 2018 january 2019 manitoba canada adults longterm opioid prescriptions enrolled n 4225 participants identified via manitoba drug program information network individuals receiving palliative care diagnosis cancer dementia excluded data analyzed july 2019 march 2020 participants clustered according primary care clinic randomized intervention codesigned directtoconsumer educational brochure sent mail usual care comparator group main outcome discontinuation opioid prescriptions participant level 6 months ascertained pharmacy drug claims secondary outcomes included dose reduction morphine milligram equivalents mme andor therapeutic switch reduction opioid use assessed using generalized estimating equations account clustering prespecified subgroup analyses age sex analysis intention treat 4206 participants 2409 573 male mean sd age 600 144 years mean sd baseline opioid use comparable groups intervention 1577 1797 mmed control 1534 1818 mmed 6 months 235 2136 participants 110 127 clusters intervention group longer filled opioid prescriptions compared 228 2070 110 124 clusters comparator group difference 00 95 ci 19 19 participants intervention group control group reduced dose 1410 660 vs 1307 631 difference 28 95 ci 0057 receipt brochure led greater dose reductions participants male difference 39 95 ci 0177 aged 18 64 years difference 37 95 ci 0272 living urban areas difference 59 95 ci 1999 compared usual care cluster randomized clinical trial significant difference prevalence opioid cessation observed 6 months intervention usual care groups however intervention resulted adults reducing opioid dose compared usual care clinicaltrialsgov identifier nct03400384