The role of simulated-experience and descriptive formats on perceiving risks of strong opioids: A randomized controlled trial with chronic noncancer pain patients

Patient Educ Couns. 2022 Jun;105(6):1571-1580. doi: 10.1016/j.pec.2021.10.002. Epub 2021 Oct 9.

Abstract

Objectives: Opioid prescription rates worldwide suggest miscalibrated risk perceptions among those who prescribe, dispense, and take opioids. Findings from cognitive science show that risk perceptions can differ systematically depending on whether people learn about risks by description or experience. We investigated the effects of descriptive and simulated experience risk formats on patients' risk perceptions and behavior regarding long-term strong opioid use.

Methods: 300 German patients with chronic noncancer pain were randomly assigned in an exploratory randomized controlled trial to either a descriptive format (fact box) or a simulated experience format (interactive simulation). Primary endpoints were subjective and objective risk perceptions and intended intake behavior.

Results: Both formats significantly improved patients' objective risk perception; patients who saw the fact box estimated some outcomes more accurately (p = .031). Formats were equally effective in improving patients' subjective risk perception in terms of opioids' harms; however, patients receiving the simulation showed a greater reduction and termination of their opioid intake (p = .030) and a higher uptake of alternative therapies.

Conclusions: Descriptive and simulated experience risk formats improve risk perceptions and behavior regarding potent but highly risky drugs.

Practice implications: To eliminate risky behavior, simulated experience formats may be superior to descriptive formats.

Keywords: Chronic noncancer pain; Description–experience gap; Drug safety; Risk communication; Risk perception; Strong opioids.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Chronic Pain* / drug therapy
  • Chronic Pain* / psychology
  • Humans
  • Opioid-Related Disorders* / drug therapy

Substances

  • Analgesics, Opioid