RecruitingNAINTERVENTIONAL

Opioid Use Post-Discharge After Ambulatory Distal Arm Surgery

This study aims to find a better way to prescribe strong painkillers (opioids) after routine hand or arm surgery at Toronto Western Hospital. Currently, there isn't a set way to do this. Researchers want to see if using a standard, evidence-based prescription can help reduce the number of unused opioid pills that patients take home, without affecting their pain relief. Patients will be randomly put into two groups: one receiving the new standard prescription, and the other receiving the usual prescription determined by their doctor. The study also looks at how different factors like anxiety, depression, or concerns about pain might affect how patients manage their pain after surgery. The ultimate goal is to improve how painkillers are given out, ensuring patients get enough relief while minimising potential waste or misuse.

At a glance

Status

Recruiting

Phase

Sponsor

University Health Network, Toronto

Enrolment target

292

Start

04 Mar 2019

Estimated completion

31 Dec 2026

Opioid Use

What is this study about?

This research study is looking into how strong painkillers, called opioids, are prescribed after a common type of surgery on the hand or arm. At Toronto Western Hospital, there isn't a single, standard way that doctors decide how many painkiller pills to give a patient when they go home after this type of operation. This study wants to change that by testing if a new, standardised prescription, based on good medical evidence, can be more effective.

The main idea is to see if this new, standard approach can reduce the number of unused opioid pills that patients are left with after their surgery. It's really important that this is achieved without compromising pain control – meaning patients should still get enough medicine to manage their pain comfortably. The study will compare this new standardised prescription to the usual way doctors decide on prescriptions.

Researchers will also be asking participants some questions about their pain, feelings of worry or sadness, and how they think about their pain. This helps them understand how these different aspects might affect a person's pain experience and how much pain relief they need. The overall aim is to improve how painkillers are given out after surgery, making it safer and more efficient for everyone.

Key takeaways

Aims to reduce unused strong painkillers after arm/hand surgery.
Compares a new standard prescription with usual doctor's practice.
Your pain control is a top priority.
Involves questionnaires and follow-up calls after surgery.
You can withdraw at any time.
Helpful for improving future pain management.

Who may be eligible?

You might be able to join this study if you are getting ready for routine surgery on your hand or forearm at Toronto Western Hospital. You need to be at least 18 years old, and the study is open to both men and women.

However, there are some reasons why you wouldn't be able to take part. For example, if you already take a lot of strong painkillers regularly (more than six 5mg oxycodone pills a day, or the equivalent), this study might not be right for you. Also, if you have conditions that make it hard to understand or manage your medication as needed, or if language barriers would prevent you from completing diaries, you wouldn't be able to participate.

Ultimately, if you decide you don't want to be in the study, you have every right to say no, and you won't be able to join.

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 having elective hand or arm surgery at Toronto Western Hospital?
Are you 18 years old or older?
Do you *not* regularly take large amounts of strong painkillers (opioids)?
Can you understand information about taking your medicines?
Do you feel comfortable completing some questionnaires and talking on the phone?

Answer every question to see your result.

What does participation involve?

If you decide to take part, you'll first get information about the study from your surgeon in the clinic. If you're happy to learn more, a research assistant will then talk to you about joining. You'll answer some questions before your surgery about your current painkiller use and your risk for misusing these medicines. You'll also complete questionnaires about any nerve pain, anxiety, depression, or if you tend to worry a lot about pain.

At the time you leave the hospital, you'll either receive the new standardised painkiller prescription or the prescription your surgeon would normally give. You'll also get a helpful leaflet encouraging you to use non-opioid pain relief alongside any strong painkillers. After you go home, a study team member will call you to check in and ask some questions at week 1, week 6, and week 12. The total duration of your participation would be about 12 weeks from your surgery date.

Potential risks and benefits

Taking part could help improve how painkillers are prescribed for many people in the future. You will receive either a standard or usual painkiller prescription, and both are designed to help manage your pain. There are no known additional health risks directly from participating in this study beyond the usual risks associated with hand/arm surgery and painkiller use. While the study aims to reduce unused pills, your pain control will be carefully monitored. You are absolutely free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Toronto Western Hospital
Verified postcode
Toronto, Canada· Recruiting

Common questions

What kind of painkiller will I get?

You might get a standard prescription for Oxycodone, Hydromorphone, or Tylenol #3 depending on your needs and if you have any allergies.

Will I still get enough pain relief?

Yes, the study is designed to make sure you have adequate pain control. Your pain will be monitored.

How long will the study involve me?

You'll be involved from before your surgery until about 12 weeks afterwards, with a few phone calls.

What if I decide not to take part?

Your decision won't affect your medical care in any way, and you'll still receive the best treatment for your surgery.

Will my personal information be kept private?

Yes, all your personal information shared for the study will be kept confidential and safe.

How to find out more

Anuj Bhatia, MD FRCPC

anuj.bhatia@uhn.ca (416) 603 5800 Official trial record

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