About

Introduction

MedSMA℞T: Adventures in PharmaCity was developed to educate adolescents about safe opioid management. This game explores the life of Shan the sheep, who recently broke their arm. Players help Shan make medication management decisions throughout the day. The goal of this game is to teach adolescents the proper way to deal with these situations and make safe decisions for themselves and for others around them. The game helps the player to learn by allowing their decisions to affect the outcome of the game. By playing MEDSMA℞T, we hope adolescents will learn ways to keep themselves and others safe by exposing them to real life conflicts they may face.

Medication Misuse

In proper dosages, medication can lead to faster recovery and act as a treatment or cure of ailments. However, when used improperly, medication can lead to many new issues that can be harmful or even fatal. Medication misuse comes from improper consumption, including taking more medication than recommended, taking medication too frequently, or taking medication that is not yours. A medical professional makes a prescription decision based on an individual's health history, metabolism, and many other factors that helps prevent dangerous situations. This is why medication must be taken as prescribed, by the person who it is prescribed to, stored in a safe and secure location, and discarded properly when expired to ensure that it poses no risk to anyone it is not meant for.

Purpose

The purpose of MedSMA℞T: Adventures in PharmaCity is to educate adolescents about safe opioid management: proper consumption, storage, and disposal of prescribed opioids. This is demonstrated through the life of Shan the sheep who encounters various instances similar to those an adolescent may face with pressure to take or give opioids. The player is meant to guide Shan to make safe decisions to learn proper care of opioids. Even if players make a mistake in guiding Shan to make healthy choices, they are able to return to the situation and attempt it again to make the safest decision. Adolescents are meant to learn to make safe choices on their own without putting themselves in a dangerous situation, so that, if these situations ever arose in real life, players would be able to make an educated and safe choice.

Goals

The main goal of MedSMA℞T: Adventures in PharmaCity is to teach adolescents how to stay safe in situations where they encounter opioid misuse. This educational game has many goals that will develop players' skills in making informed decisions surrounding proper opioid usage.

These goals include:
• Proper storage of opioids in a secure location
• Proper consumption of opioids
• Rejecting opioids not prescribed to the player
• Ensuring that the player is the only one who takes their opioids
• Taking opioids at the appropriate frequency
• Disposal of opioids in a safe location and in a safe manner

Other goals of this game are more centered towards the lessons learned by the player:
• Learning proper use of opioids and overall safety
• Application of these learned skills
• Remembering these skills for future use and education of peers

As technology advances, educational games are becoming more effective in teaching essential lessons and skills for adolescents, as they better engage this audience. Leading an adolescent through a potentially dangerous situation and demonstrating a safe choice is more impactful to their memory than simply reading or visualizing a situation. This educational game provides these experiences by showing choices, as well as the benefits and consequences that accompany them, without placing the player in danger. The engaged player will hopefully develop a stronger association within their memory, leading to better practice and action later in life.

Media

Resources

Medication Safety Resources

GenerationRx: GenerationRx is a website dedicated to spreading knowledge about safe medication practice. This website contains a wide variety of resources to provide information for using, storing, and disposing of medications safely.

Dose of Reality: Dose of Reality is a website that details the issue of painkiller abuse in Wisconsin. It gives a detailed description of how painkiller abuse can occur and how to prevent this from happening.

DisposeRx: DisposeRx is a medication management website dedicated to solving drug disposal issues. This DisposeRx provides resources to best manage medication disposal and safe practices.

EVERFI: EVERFI encourages school to provide prescription safety education to their students. Learn how you can bring the Prescription Drug Safety course to your child’s school and encourage your local school to provide prescription safety education to their students.

Operation Prevention: Operation Prevention is a program backed by Discovery Education and the DEA to provide free, online resources that promote drug abuse prevention. These resources are meant to help students, educators, and working adults learn about how they can prevent misuse of opioids and other drugs.

Project Lazarus: Project Lazarus aims to educate young adults about both the benefits and dangers of various medications, and how to safely use and dispose of them. Those who join Project Lazarus pledge sobriety and act as role models for their peers to follow and learn from.

Partnership to End Addiction: Partnership to End Addiction is a resource that connects persons to trained professionals, so they can discuss addiction and learn how to take action in the community. The Parental Helpline provides specialist help to parents or guardians who need support in treating an addiction of a loved one and is completely confidential.

Scholastic: Scholastic provides information about over the counter (OTC) medication safety for young adults as well as resources for young adults to learn about common medication safety in an interactive style. They also provide information for educators and parents.

National Resources

NAMI HELPLINE
The NAMI HelpLine is a free service that provides information, resources, and support to people living with a mental health condition, as well as their family members and caregivers.
800-950-NAMI
info@nami.org

Substance Abuse and Mental Health Services Administration (SAMHSA)
The SAMHSA hotline is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders.
Treatment Referral Helpline
1-800-662-HELP (4357)
https://www.samhsa.gov/find-help/national-helpline

If you have questions or concerns about opioid use and safety, please contact your doctor, a school counselor, or refer to www.hhs.gov/opioids.

The National Institute on Drug Abuse (NIDA) developed a guide to help parents talk with their children about opioids. We hope this booklet can help parents better understand opioids and start a conversation with their child.
National Institute on Drug Abuse (NIDA): A Letter to Parents

The National Institute on Drug Abuse (NIDA) also developed a guide specifically for teens with the goal to give them facts about opioids and help them make smart and safe choices. We hope teens will use this booklet to become more educated on opioid safety and share information about opioids with their friends, parents, teachers, and others.
National Institute on Drug Abuse (NIDA): A Letter to Teens

Common Medication Safety Tips to Know

Your Medication(s)

• Know the name and dose(s) of your medicine(s).
• Understand why the medicine is important and what it treats.
• Read your labels to learn what you are taking, how and when to take it, side effects, etc.

Take Your Medicine

• Make sure you take your medicine in the correct dose.
• Take your medicines at the right time(s).
• Renew your medications in advance so you do not run out.

Keep Your Medications Safe

• Store your medications(s) in a cool, dry place.
• Lock your medications in a cabinet to keep them away from children and pets.
• Dispose of your medications safely by taking them to a drug take back site, location, or program.
• If you cannot get to a drug take back location promptly
  • and your medicine is on the FDA flush list, your next best option is to immediately flush these potentially dangerous medicine down the toilet.
  • and your medicine is not on the flush list, you should follow these instructions to discard the medicine in your trash at home.

Other Tips

• Tell your doctor or pharmacist if you have a problem taking the drug for any reason, including cost.
• Keep a list of all medications you take.
• Know your medicine allergies.
• Report unusual side effects to your doctor or pharmacist.

In the News

“MedSMART: Adventures in PharmaCity” - Game based Learning to Teach Safe Medication Handling: This article written by the Great Lakes Addiction Technology Transfer Center (ATTC) covers an interview with the Principal Investigator, Dr. Abraham, on the serious game MedSMART: Adventures in PharmCity. This article answers many questions about the intentions of the game and how it will be used to further prescription drug knowledge in adolescents.

Breaking the Opioid Cycle: This article, written by Katie Gerhards, gives detailed information about the developmental phases of the serious game, MedSMART: Adventures in PharmCity. Its goal to help aid in the fight against opioid misuse. It also includes descriptions of the game, information from various professionals in the field, and how this game is being used to better prepare adolescents for risks they may face someday.

Rennebohm Buzz: This section of the UW-Madison School of Pharmacy’s Rennebohm Buzz covers information regarding the inspiration and application of the MedSMART game from an interview with Dr. Abraham. The article also gives details on the future of this game and possible settings for use in opioid management education.

Publications

• Abraham, O, Rosenberger, C, Birstler, J, Tierney, K. Examining adolescents’ opioid knowledge and likelihood to utilize an educational game to promote medication safety. Res Social Adm Pharm. 2021. Available online September 20, 2021. https://doi.org/10.1016/j.sapharm.2021.09.005
• Abraham, O, Thakur, T, Brasel, K, Norton, D, Rosenberger, C. Development of the adolescent opioid safety and learning (AOSL) scale using exploratory factor analysis. Res Social Adm Pharm. 2021. In Press. Available online 12 June 2021. https://doi.org/10.1016/j.sapharm.2021.06.007
• Abraham, O, Szela, L, Brasel, K, Hoernke, M. Engaging youth in the design of prescription opioid safety education for schools. J Am Pharm Assoc. Accepted for publication October 11, 2021.
• Abraham, O, Thakur, T, Brown, R. Developing a Theory-Driven Serious Game to Promote Prescription Opioid Safety Among Adolescents: Mixed Methods Study. JMIR Serious Games. 2020;8(3):e18207. Published 2020 Jul 3. doi:10.2196/18207
• Abraham, O, Tidd, M, Buechel, M, Thakur, T, Brown, R. Student pharmacists’ assessment of a serious game on opioid medication safety. Innov Pharm. 2020;11(4):Article 19. doi.org/10.24926/iip.v11i4.2937
• Abraham, O, LeMay, S, Bittner, S, Thakur, T, Stafford, H, Brown, R. Investigating serious games that incorporate medication use for patients: a systematic literature review. JMIR Serious Games. 2020;8(2):e16096. Published 2020 Apr 29. doi:10.2196/16096
• Abraham, O, Feathers, A, Grieve, LB, Babichenko, D. Developing and piloting a serious game to educate children about over-the-counter medication safety. J Pharm Health Serv Res. June 2019;10(2):235-241.
• Abraham, O, Szela, L, Thakur, T, Brasel, K, Brown, R. Adolescents perspectives on prescription opioid misuse and medication safety. J Pediatr Pharmacol Ther. 2021;26(2):133-143. doi:10.5863/1551-6776-26.2.133
• Abraham, O, Szela, L, Norton, D, Stafford, H, Hoernke, M, Brown, R. Adolescents’ Awareness about Prescription Opioid Misuse and Preferences for Educational Interventions. J Am Pharm Assoc. 2020;60(6):P978-985. doi:10.1016/j.japh.2020.07.029
• Abraham, O, Thakur, T, Brown, R. Prescription opioid misuse and the need to promote medication safety among adolescents. Res Social Adm Pharm. 2019;15(7):841-844. doi.org/10.1016/j.sapharm.2019.01.003.
• Abraham, O, Wytiaz, R, Feathers, A. Pediatric use of medication adherence apps: a qualitative analysis of the perspectives of children and parents. J Pharm Pract Res. 2019;49:2 123-129. doi: 10.1002/jppr.1460.
• Abraham, O, Chmielinski, J. Adolescents’ misuse of over-the-counter medications: the need for pharmacist-led intervention. Innov Pharm. 2018;9(3):Article 4. doi.org/10.24926/iip.v9i3.979.

Contact

If you have questions about this research, please contact the Principal Investigator, Dr. Olufunmilola Abraham by email: olufunmilola.abraham@wisc.edu.

If you have questions about the CRoME Lab, our studies, becoming a participant, or want to join the team, please contact the Research Coordinator by email: crome@pharmacy.wisc.edu.

The CRoME Lab’s mission is to develop, implement, and disseminate novel methods for improving medication safety and health behaviors for vulnerable and underserved populations, while training the next generation of researchers. Projects within the CRoME research core share the common goal of applying community-engaged, collaborative, and transdisciplinary approaches to improving medication use and health outcomes for families through education, prevention, and intervention programs. For more information, please visit our website: https://pharmacy.wisc.edu/crometeam/

Funding Support

This study was supported by KL2 grant KL2 TR002374-03 and grant UL1TR002373 to UW ICTR by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This project was also supported by the UW Prevention Research Center.