title: Decision support in addiction: The development of an e-health tool to assess and prevent risk of fatal overdose. The ORION Project.
abstract: OBJECTIVE
  The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose.
  
  
  METHODS
  In this article, we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project.
  
  
  RESULTS
  The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore, its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception.
  
  
  CONCLUSIONS
  Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness.
authors.affiliation: School of Medicine, Medical and Biological Sciences Building North Haugh, University of St Andrews, Fife KY16 9AJ, United Kingdom. Electronic address: amb30@st-andrews.ac.uk.
authors.forename: A
authors.initials: A
authors.lastname: Baldacchino
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Via Forlanini, 2-27100 Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Crocamo
authors.affiliation: School of Medicine, Medical and Biological Sciences Building North Haugh, University of St Andrews, Fife KY16 9AJ, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Humphris
authors.affiliation: School of Medicine, Medical and Biological Sciences Building North Haugh, University of St Andrews, Fife KY16 9AJ, United Kingdom; Playfield Institute, Startheden Hospital, Cupar, Fife KY15 5RR, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Neufeind
authors.affiliation: Faculty of Health, School of Pharmacy, Hornbeam Building, Keele, Staffordshire ST5 5BG, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Frisher
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, LVR-Hospital Essen, Hospital of the University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Scherbaum
authors.affiliation: Department of Mental Health, San Gerardo University Hospital, Via Pergolesi, 33-20900 Monza, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carrà
mesh_terms: D000293:Adolescent; D000328:Adult; D003661:Decision Support Techniques; D062787:Drug Overdose / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D055815:Young Adult
keywords: Decision making; Opioids; Risk