Working…
ClinicalTrials.gov
ClinicalTrials.gov Menu

Preventing Prescription Stimulant Diversion and Medication Misuse Via a Web-Based Simulation Intervention

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04885166
Recruitment Status : Recruiting
First Posted : May 13, 2021
Last Update Posted : May 13, 2021
Sponsor:
Collaborators:
Texas State University
University of Wyoming
Information provided by (Responsible Party):
Laura Holt, Trinity College

Brief Summary:
Half or nearly half of college students with prescriptions divert their stimulant medication, and a similarly high percentage misuse their medication or use someone else's prescription. Diversion may lead students to go without needed medication to mitigate their symptoms, increasing their risk for unintentional injuries and substance use. Further, diversion perpetuates the non-medical use of prescription stimulants (NMUPS), which has become increasingly common among college students. Diversion also perpetuates medical misuse of stimulants among students with prescriptions, which is associated with poorer attention-deficit/hyperactivity disorder (AD/HD) symptom management and may increase the risk for addictive disorders. There are no evidence-based interventions targeting diversion of stimulants in college students. Being approached for one's medication is a key risk factor for diversion, as is medication non-adherence and believing NMUPS and diversion are more prevalent than they are. Accordingly, in this multi-site study, the investigators will conduct a randomized, controlled trial of 300 college-attending adults with current stimulant prescriptions to examine the preliminary efficacy and feasibility of a single-session, computer-based simulation intervention (with two booster sessions) to prevent prescription stimulant diversion and medication misuse and compare it to a placebo condition. The intervention, which is grounded in social learning theory and the theory of planned behavior uniquely engages students in interactive discussions with virtual humans to (a) learn about the actual prevalence of NMUPS and diversion and their related risks, (b) practice using refusal strategies when approached for their medication in high-risk situations, and (c) understand how to effectively communicate with prescribers and avoid medication misuse. The primary aims are to determine if the intervention reduces diversion, intentions to divert, and medication misuse, and to assess user satisfaction with the intervention. The secondary aims are to examine change in potential mechanisms of action targeted in the intervention, such as self-efficacy to resist diversion, knowledge about diversion and NMUPS, use of behavioral strategies to resist requests for one's medication, and prescriber communication. If effective, the intervention could be readily and widely disseminated to college counseling centers, psychiatrists, pediatricians, and other prescribers.

Condition or disease Intervention/treatment Phase
Prescription Drug Abuse (Not Dependent) Intentional Misuse Other: Web-based placebo presentation Behavioral: Web-based simulation active intervention Not Applicable

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 300 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Official Title: Preventing Prescription Stimulant Diversion and Medication Misuse Via a Web-Based Simulation Intervention
Actual Study Start Date : May 4, 2021
Estimated Primary Completion Date : January 31, 2023
Estimated Study Completion Date : July 1, 2023

Arm Intervention/treatment
Experimental: Web-based simulation intervention
Participants in this condition will receive psychoeducation about stimulant medication diversion, stimulant medication misuse, and will practice navigating and resisting requests for their medication with a virtual human.
Behavioral: Web-based simulation active intervention
This intervention engages students in interactive discussions with virtual humans to (a) learn about the actual prevalence of NMUPS and diversion and their related risks, (b) practice using refusal strategies when approached for their medication in high-risk situations, and (c) understand how to effectively communicate with prescribers and avoid medication misuse.

Placebo Comparator: Placebo condition
Participants in this condition will learn about psychological conditions that affect college students most often (e.g., depression), causes of those conditions, and pharmacological/behavioral treatments for those conditions.
Other: Web-based placebo presentation
This presentation will discuss the prevalence of psychological disorders in college students, their etiologies, psychiatric medications, and students' personal experiences navigating college with a diagnosis of an anxiety and learning disorder, respectively. Attention-deficit/hyperactivity disorder and stimulant medications will be addressed, but diversion and medication misuse will not be discussed.




Primary Outcome Measures :
  1. Change in frequency of prescription stimulant diversion [ Time Frame: baseline, 3-months, 6-months ]
    participants will note how many times they have engaged in diversion (i.e., giving away, selling, or trading one's prescribed medication)

  2. Change in intention to divert prescription stimulant medication [ Time Frame: baseline, 3-months, 6-months ]
    How likely is it that you will give away, sell, or trade your stimulant medication in the next three months?

  3. Change in frequency of prescription stimulant medication misuse [ Time Frame: baseline, 3-months, 6-months ]
    participants will indicate any instances of (a) using alternative routes of administration, (b) taking more than your recommended dose, (c) taking less than your recommended dose, (d) taking someone else's stimulant medication, (e) taking your stimulant with other drugs in order to experience intoxicating effects, or (f) intentionally getting high on your prescribed stimulant medication?

  4. User satisfaction with the simulation/placebo [ Time Frame: baseline (immediately after simulation or placebo presentation) ]
    We will assess the usefulness, information quality, and interface quality of the simulation using the 13-item Post-Study System Usability Questionnaire. A mean score of 1 indicates lowest level of satisfaction, while a mean score of 7 would indicate the highest level of satisfaction.

  5. Usability of the simulation/placebo [ Time Frame: baseline (immediately after simulation or placebo presentation) ]
    Participants will respond to 15 items related to the perceived usefulness, user control, and impact of the simulation/placebo. A mean score of 1 would indicate the lowest level of perceived usability; a mean score of 5 would indicate the highest rating of usability.

  6. 1 month booster engagement [ Time Frame: 1 month ]
    We will determine engagement in the online booster session #1 on a 0-5 scale by summing the number of correct answers to the five comprehension questions embedded in the online booster.

  7. 2 month booster engagement [ Time Frame: 2 months ]
    We will determine engagement in the online booster session #2 on a 0-5 scale by summing the number of correct answers to the five comprehension questions embedded in the online booster.


Secondary Outcome Measures :
  1. Change in self-efficacy to resist prescription stimulant diversion [ Time Frame: baseline, 3-months, 6-months ]
    Participants will rate their confidence to (1) resist giving away their medication, (2) resist selling their medication.

  2. Resistance strategy use [ Time Frame: 3- and 6-months ]
    If, since the last assessment, participants indicate they have been approached for their stimulant medication, they will be asked to describe how they responded (gave/sell/traded medication or not) to each request. In cases where they did not divert their medication, they will be asked to indicate (open-ended response) how they turned down the request.

  3. Change in perceived behavioral norms [ Time Frame: baseline, 3-months, 6-months ]
    Participants will indicate, on a scale from 0-100, what percent of students, on average, engage in (1) diversion and (2) non-medical prescription stimulant misuse.

  4. Change in risk perception [ Time Frame: baseline, 3-months ]
    We will assess perceived legal risks associated with prescription stimulant diversion. We will assess perceived harm from non-medical prescription stimulant use and medical misuse by asking: "How much do people risk harming themselves (physically or in other ways) if they "take stimulants non-medically?" or "use their prescription in a way a prescriber did not intend?

  5. Change in communication with prescriber [ Time Frame: baseline, 3-months, 6-months ]
    Number of times participants communicated with their prescriber regarding their adherence to their prescription and any concerns they have regarding the dose, frequency of administration, and/or side effects in past 90 days.


Other Outcome Measures:
  1. Other substance use [ Time Frame: baseline, 3-months, 6-months ]
    Participants will report any occasions of binge drinking, and/or marijuana, cocaine, heroin, methamphetamine, or hallucinogen use, or other prescription drug misuse in the previous 90 days.

  2. Conduct problems [ Time Frame: baseline ]
    Participants will report on the frequency with which they engaged in 11 problem behaviors before age 18

  3. Change in Attention-Deficit/Hyperactivity Disorder-related impairment [ Time Frame: baseline, 6-months ]
    Participants will report on the extent to which they have experienced problems in social, academic, familial, and vocational circumstances. A positive mean change score will indicate that participants experience an increasing level of impairment over the study period, while a negative mean change score will indicate improvement in impairment.

  4. Accidental injuries [ Time Frame: 6-months ]
    Participants will note whether they experienced any accidental injuries in the prior 6 months (e.g., car accidents, burns, etc.).



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   17 Years to 25 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Undergraduate or graduate student at Trinity College (CT); University of Wyoming; Texas State University.
  • Will be enrolled at Trinity College (CT); University of Wyoming; Texas State University 6-months from their baseline study session.
  • Have a recent (within the past 3 months) prescription for a stimulant medication
  • Between the ages of 17 and 25.

Exclusion Criteria:

  • None.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04885166


Contacts
Layout table for location contacts
Contact: Laura Holt, PhD 203-623-8470 Laura.Holt@trincoll.edu

Locations
Layout table for location information
United States, Connecticut
Trinity College Recruiting
Hartford, Connecticut, United States, 06106
Contact: Laura Holt, PhD    203-623-8470    Laura.Holt@trincoll.edu   
United States, Texas
Texas State University Recruiting
San Marcos, Texas, United States, 78666
Contact: Ty Schepis, PhD    512-245-6805    schepis@txstate.edu   
United States, Wyoming
University of Wyoming Recruiting
Laramie, Wyoming, United States, 82071
Contact: Alison Looby, PhD    307-314-2314    alooby@uwyo.edu   
Sponsors and Collaborators
Trinity College
Texas State University
University of Wyoming
Layout table for additonal information
Responsible Party: Laura Holt, Associate Professor of Psychology, Trinity College
ClinicalTrials.gov Identifier: NCT04885166    
Other Study ID Numbers: 1R34DA048345-01A1 ( U.S. NIH Grant/Contract )
First Posted: May 13, 2021    Key Record Dates
Last Update Posted: May 13, 2021
Last Verified: May 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Laura Holt, Trinity College:
diversion
Additional relevant MeSH terms:
Layout table for MeSH terms
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders