(P003) INVOLVING END-USERS IN THE DESIGN OF A DIGITAL OPIOID SAFETY INTERVENTION FOR ADOLESCENTS AND YOUNG ADULTS (AYA) WITH INFLAMMATORY BOWEL DISEASES (IBD): A QUALITATIVE ANALYSIS OF PATIENTS AND CLINICIANS

Background.  Opioid overdoses, a leading cause of death among adolescents and young adults (AYA), often result from chronic opioid use. Opioid overdose risk is especially high among AYA with chronic digestive disorders, such as inflammatory bowel diseases (IBD), given their prevalence (about 1 in 5) of using opioids chronically. To identify AYA patient and clinician needs and expectations that should be considered in the design of a digital opioid safety intervention, Chronic Opioid Use Assessment & Screening Tool (COAST), through the lens of human-centered design.

 Methods. Human-centered design research steps include defining the problem and empathizing with end-user needs, followed by brainstorming, prototyping, and testing new solutions. Focusing on the “defining” and “empathizing” steps, we conducted semi-structured interviews with AYA IBD patients and IBD-focused clinicians (gastroenterologists, surgeons, and nurses) to examine: (1) patients’ experiences and perceptions on pain management, opioid use, and transitions to adult care; and (2) clinicians’ experiences and perceptions on monitoring patients with pain and prescribing opioids in their practice. Interviews were thematically analyzed to identify emerging themes.

 Results. Four patients and 13 clinicians participated. We grouped themes representing the ideal attributes and needs for an opioid safety intervention into 3 categories: (1) overarching needs; (2) patient-facing needs; and (3) clinician- and system-level needs. In the first category (overarching needs), themes reported included the need for an opioid safety intervention to seamlessly fit into multidisciplinary, chronic care, support AYA as they transition to independence, and acknowledge that every patient is different. In the second category (patient-facing needs), themes highlighted the need to routinely acknowledge and assess patients’ lived pain experiences, set clear expectations about pain management, and connect patients with safe and effective non-opioid approaches to address pain (including non-pharmacologic approaches). In the third category (clinician- and system-level needs), themes identified were primarily to account for pain management received outside of the IBD clinic, efficiently fill information gaps around individual patient risk for unsafe opioid use, and coordinate opioid safety efforts across clinical teams.

 Conclusion. Beyond delineating risk of unsafe opioid use, AYA IBD patients and IBD-focused clinicians underscored many other needs for a digital opioid safety tool in this clinical setting (e.g. routinely assessing lived pain experiences, connecting patients with safe pain management strategies). Findings will directly inform subsequent design steps, including prototyping and testing the COAST intervention with continued active engagement of AYA IBD patients and IBD-focused clinicians.