RecruitingNAINTERVENTIONAL

Reducing Opioid Use for Chronic Pain Patients Following Surgery

Patients who live with ongoing pain often take strong painkillers called opioids, but these can have serious risks. A hospital in Toronto has created a special program called the Transitional Pain Service Program (TPSP) to help people manage their pain and slowly reduce their need for opioids after surgery. This study will check how well this program works. It includes pain education, a type of talking therapy called Acceptance and Commitment Therapy (ACT), and a mobile app to help people manage their pain themselves. Doctors hope this program will help people find a good balance between the benefits and potential problems of using opioids, leading to better long-term health and well-being.

At a glance

Status

Recruiting

Phase

Sponsor

University Health Network, Toronto

Enrolment target

210

Start

15 Oct 2018

Estimated completion

31 Dec 2026

Chronic Pain Opioid Use Postoperative Pain Opioid Dependence

What is this study about?

This study is about helping people who have ongoing pain and use strong painkillers, called opioids, especially after having surgery. While opioids can help with pain, doctors are worried about the risks of using them for a long time. That's why a hospital in Toronto has developed a special program aimed at making sure people can manage their pain effectively without relying too much on these strong medications.

The program, called the Transitional Pain Service Program (TPSP), offers different ways to help. This includes teaching people about pain, using a type of therapy called 'Acceptance and Commitment Therapy' (ACT) which can help you cope with difficult thoughts and feelings, and providing a mobile app for self-management. The main goal is to find out if these tools can help patients reduce the amount of opioids they take after surgery, or even stop them altogether, while still keeping their pain under control. The team also wants to make sure people are as healthy and well as possible in the long run.

To see how well the TPSP works, researchers will do a few things. First, they will try the program in six different hospitals. They'll ask about 210 patients who are already taking opioids and are having surgery to take part. Some will get the new TPSP program, and others will get standard care. After a year, they'll check if the people in the TPSP group were able to reduce or stop their opioids while their pain remained managed. They will also look at how the program affects the healthcare system and talk to patients and healthcare providers to understand their experiences.

Key takeaways

This study explores a new program to help people manage chronic pain after surgery.
The program aims to reduce reliance on strong opioid painkillers.
It combines pain education, talking therapy (ACT), and a mobile app.
The study will follow participants for one year after their surgery.
It's for people taking opioids for chronic pain before surgery.
Participation is voluntary, and you can withdraw at any time.

Who may be eligible?

To be part of this study, you need to be 18 years old or older. You must also be taking opioid painkillers for at least a month before your operation, and the dose needs to be somewhere between 10 to 400 milligrams of oral morphine equivalent each day. You can be having almost any type of surgery, but it can't be for end-of-life care or an organ transplant. You also need to be able to read and understand English, as there will be questionnaires, and have a personal email address so you can use the mobile app that's part of the program.

However, some people won't be able to join. If you are having palliative (end-of-life) care, an organ transplant, or if you are taking specific opioid medications like Methadone or Buprenorphine, you won't be eligible for this study. The study wants to gather a clear picture of how the new program works for a specific group of people with chronic pain.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Are you currently taking opioid painkillers for at least a month before your surgery?
Do you have a personal email address?
Are you having surgery, but not for end-of-life care or an organ transplant?
Can you read and understand English?

Answer every question to see your result.

What does participation involve?

If you take part in this study, you will be assigned to either receive the new Transitional Pain Service Program (TPSP) or continue with your usual care. The TPSP involves learning about pain, participating in Acceptance and Commitment Therapy (ACT) sessions (which are a type of talking therapy), and using a mobile app to help manage your pain. The study will last for about a year after your surgery. During this time, you will have regular check-ups and assessments to monitor your pain levels, how much opioid medication you are taking, and your general well-being. These might include questionnaires and discussions with the study team. The goal is to see if the TPSP helps you manage your pain and reduce your opioid use over this year.

Potential risks and benefits

Participating in this study might offer you the benefit of learning new ways to manage your pain and potentially reduce your reliance on opioid medications, which could improve your long-term health. However, as with any study, there could be some risks, such as additional appointments or time commitment for assessments, and the therapies might bring up difficult emotions. You might also find that the program doesn't work for you. It's very important to remember that joining this study is completely voluntary, and you have the right to withdraw at any time without giving a reason, and this will not affect your future medical care.

Locations (1)

Toronto General Hospital- University Health Network
Verified postcode
Toronto, Canada· Recruiting

Common questions

What are opioids?

Opioids are strong prescription painkillers that can help with severe pain, but they can also come with risks if used long-term.

What is 'Acceptance and Commitment Therapy' (ACT)?

ACT is a type of talking therapy that helps people learn to accept difficult thoughts and feelings, and commit to actions that align with their values, even when pain is present.

Will I have to stop taking my painkillers completely?

The program aims to help you reduce your opioid use, and for some, that might mean stopping them. However, it's about finding a balance to manage your pain safely and effectively.

How long will the study last if I join?

If you take part, the study will follow your progress for one year after your surgery to see the long-term effects of the program.

What is the mobile app for?

The mobile app is a tool designed to help you manage your chronic pain yourself, complementing the education and therapy you receive.

How to find out more

Karim Ladha, MD

karim.ladha@uhn.ca 416-719-0030 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.