Prevention of Opioid Use Disorder After Surgery

Summary

The objective of this study is to design, implement, and pilot test a multi-faceted intervention to support safer opioid prescribing, self-administration, and monitoring and reduce persistent opioid use and opioid use disorder for patients transitioning to the community setting after major orthopedic surgery. The multi-faceted intervention includes: 1) communication with outpatient providers and counseling of patients and caregivers at hospital discharge; 2) standardized opioid prescribing discharge order sets for each type of surgery; 3) an outpatient pain management follow-up visit embedded within routine post-operative care for managing pain and opioid use, and 4) a mobile patient-reported outcomes application for assessing pain, function, and possible development of opioid use disorder (OUD). The primary outcome will be persistent opioid use (in the 6 months after surgery) based on state-wide prescription data. Secondary outcomes will include the total morphine-equivalent dose of opioids prescribed at discharge; total post-operative opioids dispensed in the 6 months after surgery; and self-reported opioid misuse, pain and function 90 and 180 days after surgery.

Conditions

• Opioid-use Disorder
• Opioid Dependence
• Opioid Use

Interventions

BEHAVIORAL

Discharge Order Sets

Discharge order sets will be implemented in the electronic health record and will provide surgeons a guideline for a recommended dose and duration of opioids for each commonly performed orthopedic surgery.

BEHAVIORAL

Pharmacist-Led Discharge Counseling and Communication

Two visits by a trained inpatient pharmacist, including an intake visit to determine previous barriers to safe medication use, and a discharge counseling session with patients and caregivers regarding safe and effective opioid use after discharge; pharmacist communication with providers regarding the post-discharge pain management plan.

BEHAVIORAL

Post-discharge Pain Management Follow-up

An outpatient pharmacist pain management follow-up visit (with additional contact as needed) embedded within routine post-operative care for managing pain and opioid use.

BEHAVIORAL

Patient Engagement Pain Management App

A mobile patient-reported outcomes application for assessing pain, function, and possible development of opioid use disorder.

Sponsors & Collaborators

• Ohio State University

  collaborator OTHER

• Brigham and Women's Hospital

  lead OTHER

Principal Investigators

• Jeffrey L Schnipper, MD, MPH · Brigham and Women's Hospital

Study Design

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-07-02

Primary Completion

2023-12-15

Completion

2024-01-01

Countries

• United States

Study Locations