Mobile app may reduce prescription opioid misuse after cesarean section

Key takeaways:

• Women using an evidence-informed mobile app had a 92% reduction in odds for prescription opioid misuse vs. nonusers.
• Women who did not use the app had a seven times higher opioid misuse risk vs. app users.

Women who used the Continuous Precision Medicine mobile application had a lower likelihood of misusing prescription opioids after cesarean section vs. nonusers, researchers reported in BMC Pregnancy and Childbirth.

Continuous Precision Medicine developed the CPMRx software using evidence-informed tools to aid clinicians in understanding how patients can utilize the least amount of prescription medication while obtaining the most benefit.

“Smartphone applications have recently been widely integrated into health care. Their use has been demonstrated in relation to medication adherence, consent information and management of substance use disorders,” Annabelle Abdo, DO, a resident in the department of obstetrics, gynecology and reproductive sciences at Temple University Lewis Katz School of Medicine, and colleagues wrote. “Of the smartphone apps that are currently in existence, many have shown high participation and satisfaction rates among patient users as well as increased efficiency and efficacy in health care.”

Abdo and colleagues conducted a randomized controlled trial with 58 women (mean age, 28.5 years) who underwent cesarean section delivery. For phase 1 and phase 2, all women were randomly assigned to the control group (n = 16 and n = 18) or an experimental group (n = 15 and n = 9), which included standard care plus use of the CPMRx mobile app to help manage pain postoperatively.

Primary outcome was morphine milligram equivalents. Secondary outcomes included delay to dosages, decrease of usage and pain scores.

Prescription opioid misuse differed significantly with a 92% reduction in odds of misuse for the experimental group compared with the control group (OR = 0.08; 95% CI, 0.01-0.74; P = .03). In addition, women in the control group had a seven times higher risk for opioid misuse compared with women in the experimental group (P = .05).

Of the 21 women in phase 1 who did not misuse opioid prescriptions, the average number of used pills was 2.7. Overall, 95% of women used fewer than nine pills, 90% used fewer than seven pills, 75% used fewer than five pills and 50% used fewer than two pills.

“Systematically right-sizing prescriptions, including for subgroups, may decrease both patient- and community-level risk of opioid misuse and reduce public health burden,” the researchers wrote.