# Decision-Making Factors for Therapeutic Opioid Use after Emergency Care

> **NIH NIH K08** · UNIVERSITY OF CINCINNATI · 2021 · $191,014

## Abstract

PROJECT SUMMARY/ABSTRACT
This career development award will provide didactic and experiential training and mentorship necessary for the
candidate to become an independent and fully-funded health services researcher focused on the development
and testing of health-oriented emergency department strategies to improve primary and secondary prevention
of substance use disorders (SUD). The research plan focuses specifically on the epidemic of opioid use
disorder (OUD), fueled by incident OUD which has been largely iatrogenic (i.e., prescribed opioids leading to
OUD despite being used as directed for therapeutic purposes). Guidelines and legislation have targeted
provider prescribing, but the role of the patients in therapeutic decision-making has not been addressed
directly. There is an urgent and imperative need to understand factors influencing patients' motivation
to seek and/or use opioids and engage them as stakeholders in the balance of pain and OUD risk.
Emergency departments (EDs) have been a prime subject of opioid prescribing interventions, because they
frequently initiate or continue therapeutic opioids and do so in circumstances with little provider-patient
familiarity or follow-up care. The objective of this study is to measure and model associations between ED
patient decision-making factors (knowledge, attitudes, beliefs, and perceptions) and patient motivation to use
opioids for pain relief or avoid OUD risk. The central hypothesis is that ED patients' desire for therapeutic
opioids and decision to use them when available results from potentially modifiable cognitive factors. We will
conduct a mixed-methods study using a combination of focus groups, cross-sectional quantitative survey, and
longitudinal follow-up of opioid seeking and therapeutic use after ED visit for acute pain to accomplish the
following aims: 1) Establish a qualitative understanding of cognitive factors influencing patient motivation to use
opioids for acute pain; 2) Develop the Decisions To use Opioids (DTO) survey instrument to quantify potential
cognitive determinants of patient motivation to use opioids for acute pain; including 2a) Psychometric testing of
the DTO, and 2b) Measure the contribution of cognitive factors to patient motivation to seek/use opioids.
This will promote highly impactful advances in the field of iatrogenic OUD, by informing shared decision-
making models and new behavioral interventions. The research plan is also highly complementary to the
career development of an independent clinical researcher focused on the development of primary and
secondary SUD prevention strategies in the ED setting, providing experience in mixed-methods, longitudinal
prospective clinical research, survey validation, and predictive modeling, as well as rich preliminary data to
support future investigation under the direction of a highly qualified and multidisciplinary team of mentors. The
quintessential contribution of this research will be to engage the patient in...

## Key facts

- **NIH application ID:** 10127330
- **Project number:** 1K08DA049948-01A1
- **Recipient organization:** UNIVERSITY OF CINCINNATI
- **Principal Investigator:** Brittany E Punches
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $191,014
- **Award type:** 1
- **Project period:** 2021-04-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10127330

## Citation

> US National Institutes of Health, RePORTER application 10127330, Decision-Making Factors for Therapeutic Opioid Use after Emergency Care (1K08DA049948-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10127330. Licensed CC0.

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