Screening in Trauma for Opioid Misuse Prevention (STOMP): study protocol for the development of an opioid risk screening tool for victims of injury.
BACKGROUND
Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population remain under-investigated. The current project seeks to develop and pilot the implementation of a screening tool for opioid risk at American College of Surgeons (ACS) Level I and Level II trauma centers.


METHODS
The project began with an online survey, which was sent to Wisconsin trauma center medical directors and trauma coordinators for the purpose of gathering information on current substance use screening practices. Next, a focus group of trauma center staff was convened to discuss barriers and facilitators to screening, resources available and needed to support trauma patients with opioid use disorders, and measurable clinical observations that could indicate a patient's potential risk for opioid misuse. Data from the surveys and focus group were combined to inform the data collection instruments that are currently being administered to patients recruited from the University of Wisconsin Hospital Trauma Inpatient and Orthopedic Surgery Services. Eligible and consenting patients complete standardized measures of socio-demographics, substance use history, opioid misuse risk, mental health, medical history, and injury and pain severity. Follow up visits at weeks 4, 12, and 24 after hospital discharge assess hypothesized risk factors for opioid addiction and opioid use disorder diagnosis. At the completion of patient data collection, a forward stepwise regression will identify factors of most significant risk of the development of opioid use disorder after traumatic injury. This modeling will inform the development of a novel opioid risk screening tool, which will undergo pilot implementation at 4 Wisconsin ACS Level I and Level II trauma centers, using an evidence-based implementation strategy with roots in systems engineering.


DISCUSSION
Positive findings from the proposed work would lead to improved, standardized opioid risk screening practices among victims of traumatic injury. The ultimate goal of this and future work is to reduce the likelihood of opioid misuse, addiction, and related complications, such as overdose and death. Trial registration Clinicaltrials.gov registration number: NCT02861976. Date of registration: Feb 9, 2016.
['Brown|Randall|R|0000-0002-5445-8119', 'Deyo|Brienna|B|', 'Riley|Chelsea|C|', 'Quanbeck|Andrew|A|', 'Glass|Joseph E|JE|', 'Turpin|Rebecca|R|', 'Hetzel|Scott|S|', 'Nicholas|Christopher|C|', 'Cruz|Maireni|M|', 'Agarwal|Suresh|S|']
D000328:Adult D000368:Aged D000701:Analgesics, Opioid D005260:Female D006801:Humans D008297:Male D008603:Mental Health D008875:Middle Aged D009293:Opioid-Related Disorders D059408:Pain Management D063487:Prescription Drug Misuse D018570:Risk Assessment D015813:Substance Abuse Detection D011795:Surveys and Questionnaires D014947:Wounds and Injuries D055815:Young Adult
Screening Trauma Opioid misuse Opioids Injury Opioid addiction Opioid use disorder Risk factors Opiates Opioid abuse