Evidence map›Paper›PMID 31286636›Full record

ArticlePharmacoepidemiology and drug safety2019

Implementation fidelity of patient-centered prescription label to promote opioid safe use.

Danielle M McCarthy, Andrea M Russell, Morgan R Eifler, Lauren A Opsasnick, Abigail E Lyden, Stephanie J Gravenor, Enid Montague, Scott I Hur, Kenzie A Cameron, Laura M Curtis and 1 more

Abstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMCAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Danielle M McCarthyDepartment of Emergency Medicine, Northwestern University, Chicago, Illinois.ORCID 0000-0002-9038-2852
Andrea M RussellHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Morgan R EiflerHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Lauren A OpsasnickHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Abigail E LydenCollege of Pharmacy, Rosalind Franklin School of Medicine and Science, North Chicago, Illinois.
Stephanie J GravenorDepartment of Emergency Medicine, Northwestern University, Chicago, Illinois.
Enid MontagueSchool of Computing, DePaul University, Chicago, Illinois.
Scott I HurHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Kenzie A CameronDivision of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Laura M CurtisHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.
Michael S WolfHealth Literacy and Learning Program, Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois.ORCID 0000-0002-4342-6517

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
EHR Based Medication Complete Communication Strategy to Promote Safe Opioid UseR18HS023459 · AHRQ · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MCCARTHY, DANIELLE M · 2014 to 2016
$1.5M
AHRQ HHS R18 HS023459AHRQ HHS R18HS023459NCATS NIH HHS UL1TR001422
6 · The paper itself

Abstract

purposePatient-centered labels may improve safe medication use, but implementation challenges limit use. We assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording.

methodsAs part of a larger investigation, patients received TWS prescriptions (eg, Take: 1 pill if you have pain; Wait: at least 4 h before taking again; Stop: do not take more than 6 pills in 24 h). Prescriptions labels recorded at follow-up were classified into three categories: (1) one-step wording (Take 1 pill every 4 h [without daily limits]), (2) two-step wording (Take 1 pill every 4 h; do not exceed 6 pills/day), and (3) three-step wording. There were three subtypes of three-step wording: (3a) three-step, not TWS (three deconstructed steps, not necessarily TWS wording), (3b) TWS format, employing three steps with leading verbs, but "with additions or replacements" (eg, replaced "do not take" with "do not exceed"), and (3c) verbatim TWS.

resultsTwo hundred eleven participants completed follow-up. Mean age was 44.3 years (SD 14.3); 44% were male. One-step bottles represented 12% (n = 25) of the sample, whereas 26% (n = 55) had two-step wording. The majority (44%, n = 93) had three-deconstructed steps, not TWS (3a); 16% (n = 34) retained TWS structure, but not verbatim (3b). Only 2% (n = 4) displayed verbatim TWS wording (3c). All category three labels (utilizing deconstructed instructions) were considered adequate implementation (62%).

conclusionsExact intervention adherence was not achieved in the majority of cases, limiting impact. Nonetheless, community pharmacies were responsive to new instructions, but higher implementation reliability requires additional supports.

Indexed as

AdultAnalgesics, OpioidCommunity Pharmacy ServicesDrug LabelingDrug PrescriptionsFemaleFollow-Up StudiesGuideline AdherenceHealth LiteracyHealth Plan ImplementationHumansMaleMiddle AgedOpioid-Related DisordersPainPatient-Centered CareAnalgesics, OpioidPrescription Drugsacetaminophen-hydrocodone drug combinationdrug labelinghealth literacypharmaciespharmacoepidemiology

Identifiers

PMID31286636
PMCPMC13429229

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.