Assessing the effectiveness of a narrative-based patient education video for promoting opioid tapering.
Bo Feng, Yining Z Malloch, Richard L Kravitz and 4 others
PMID 32900605WHAT IT FOUND
A patient-story video did not increase patients’ stated intention to taper compared with a CDC pamphlet, but it raised their belief that tapering can work and their confidence to try it.
Key findings
01The video did not significantly change tapering intention compared with the pamphlet.
02Compared with the CDC pamphlet, the narrative video raised tapering self-efficacy (video mean 3.97, pamphlet mean 3.60; adjusted mean difference 0.32, 95% CI 0.09 to 0.55, P < 0.001).
03Compared with the CDC pamphlet, the narrative video raised perceived tapering effectiveness (video mean 4.06, pamphlet mean 3.67; adjusted mean difference 0.34, 95% CI 0.13 to 0.54, P < 0.001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited from an online marketplace sample, not a clinic, and were not selected by clinicians as appropriate tapering candidates. The mean age was 37 years, younger than typical national samples of patients on opioids for chronic pain. Opioid dose was not assessed, so some participants may have been on low-dose or intermittent opioids for which tapering may not be clinically indicated. Only 239 of 365 eligible participants took part in the intervention. Outcomes were self-reported perceived effectiveness, self-efficacy, and intention; opioid dose was not assessed. The video and pamphlet were not matched for exposure time: median time with video was 9 minutes, median time with pamphlet was 36 seconds.
Declared interests
NIH extramural support is listed; no author conflict-of-interest declaration is provided.
The easy way to misread this
Do not conclude that this video will cause patients to taper or that it works in clinic. It only increased self-reported belief and confidence compared with a pamphlet, did not change tapering intention, and was tested in an online sample rather than patients selected by clinicians as appropriate tapering candidates.