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The bags were primarily distributed at pharmacies, though pharmacists delivered bags to some patients. The primary outcome was disposal of leftover opioids (effectiveness). Secondary outcomes were patient willingness to dispose and factors associated with disposal (effectiveness), recalling receipt of the bag (reach), and recalling receipt of bags and disposal over time (maintenance). We used a modified Poisson regression to evaluate the relative risk of disposal. Inverse probability of treatment weighting, based on propensity scores, was used to account for differences between survey responders and non\u2010responders and reduce nonresponse bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection\/Extraction Methods<\/jats:title><jats:p>From August 2020 to May 2021, we surveyed patients 2\u2009weeks after discharge (allowing for home opioid use). Eligibility criteria were age \u226518, English being primary language, valid email address, hospitalization \u226430\u2009days, discharge home, and an opioid prescription sent to a system pharmacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>We identified 5134 patients with 2174 completing the survey (response rate 42.3%). Among respondents, 1375 (63.8%) recalled receiving the disposal bag. Among 1075 respondents with leftover opioids, 284 (26.4%) disposed, 552 (51.3%) planned to dispose, 79 (7.4%) did not plan to dispose, 69 (6.4%) had undecided, and 91 (8.5%) had not considered disposal. Recalling receipt of the bag (incidence rate ratio [IRR] 1.25, 95% confidence interval [CI] 1.13\u20131.37) was positively associated with disposal. Patients who used opioids in the last year were less likely to dispose (IRR 0.82, 95% CI 0.73\u20130.93). Disposal rates remained stable over the study period while recalling receipt of bags trended up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A pragmatic implementation of a disposal intervention resulted in lower disposal rates than prior trials.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14227","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T05:59:52Z","timestamp":1694584792000},"page":"1256-1265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating a health system\u2010wide opioid disposal intervention distributing home\u2010disposal bags"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8605-2631","authenticated-orcid":false,"given":"Lyen C.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Surgery University of Utah  Salt Lake City Utah USA"},{"name":"Huntsman Cancer Institute University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josh","family":"Bleicher","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Torre","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Presson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan M.","family":"Millar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"},{"name":"Informatics, Decision\u2010Enhancement, and Analytic Sciences (IDEAS) Center VA Salt Lake City Health Care System  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin S.","family":"Brooke","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A.","family":"Kaphingst","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute University of Utah  Salt Lake City Utah USA"},{"name":"Department of Communication University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex H. 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