Applying Patient and Health Professional Preferences as part of Co-designing a New Digital Brief Intervention to Reduce Prescription Opioid Harm (Preprint)

BACKGROUND Few personalized, behavioral treatments are available to reduce opioid-related harm for patients with chronic non-cancer pain (CNCP). OBJECTIVE We report on the second co-design phase of a digital brief intervention (BI) based on patient and health professional preferences. METHODS Eligible patients with CNCP (N = 18; 10 females; Mage = 49.5) from public hospital waitlists and health professionals (N = 5; 2 females; Mage = 40.2) from pain and addiction clinics completed semi-structured phone interviews or focus groups exploring on BI preferences, needs, and implementation considerations. Grounded theory was used to thematically analyse data. RESULTS From patient reports, nine suggestions related intervention content were identified: Non-pharmacological pain treatments; Personalized medication plan; Opioid use reflection and education; Biopsychosocial pain knowledge; Pain psychology education; Holistic assessment and feedback; Broader person-centered goals; Happiness and comfort goals; Varied coping skills options. Six patient suggestions related to the process and guiding principles: Therapist-guided; Engaging features; Compassionate, responsive, person-centered care; Digital solution maximizing reach; Educate and normalize system/policy challenges; Intervention engagement across settings. Finally, five themes were reflected in health professional reports: Digital health use rare but desired; Digital health useful for patient monitoring/accessing support; Patient motivation important; Digital BI app likely beneficial and at multiple care points; Safe medications use/managing pain goals. Reported barriers from health professionals were intervention intensity, potential costs, and patient responsiveness. CONCLUSIONS Digital BIs are highly desired by patients with CNCP and health professionals. This co-design study identified key content areas, principles, enablers and barriers to guide development of such programs.