Screening, brief intervention, multidisciplinary consultation and treatment advice for prescription opioid misuse at the ED

Strong painkillers such as oxycodone and tramadol are increasingly prescribed in the Netherlands. Unfortunately, some people use these drugs in a way that is not intended, which can lead to health problems. People with these kinds of problems regularly come to the emergency department (ED). This presents an opportunity to discuss their medication use and offer them help if necessary. This study investigates the feasibility of screening these patients in the ER with a questionnaire. If this shows possible problematic use, a brief motivational conversation with the attending physician follows. Then the patient's situation is discussed in a multidisciplinary consultation (MDO) with various medical specialists. Afterwards, the patient receives a personal treatment recommendation via the general practitioner.

The purpose of this study is to investigate the feasibility of introducing a new practice in the Emergency Department for patients who may be problematic users of prescription opioids. This involves using a questionnaire, a short motivational interview and a consultation with different specialists. Together, they prepare a personalized treatment recommendation. The study will examine whether this approach is feasible in practice, and how patients and caregivers experience it.

The study takes place in LUMC's emergency department. Patients 18 years of age or older who use opioids (such as oxycodone or tramadol) are given a questionnaire about their medication use. If it appears that someone may be using opioids in a problematic manner, a brief discussion with the attending physician follows. Then the patient is discussed in a consultation with several specialists, such as a pain physician, psychologist, addiction specialist, family physician and emergency room physician. Together, they prepare a personalized treatment recommendation. A few weeks later, the patient is discussed with them by telephone about how they are doing now and how they experienced the advice and counseling. The caregivers involved also fill out questionnaires about their experiences with this approach.

This study is testing a new intervention for patients who may be problematic opioid users. The intervention consists of three parts: a questionnaire in the emergency department, a short motivational interview with the attending physician, and a discussion of the patient in a consultation with several medical specialists. Based on this, the patient receives a personalized treatment recommendation through the primary care physician.

Participants fill out a short questionnaire and, if they have an elevated score, receive a brief interview with a physician. Their situation is discussed in a consultation with specialists; they themselves do not attend. After three months there is a telephone evaluation interview. The load is low and there are no medical risks. Participants are adult patients taking opioids who do not have cancer. Participation is voluntary and without compensation.