DE-eSCALation of Opioids Post-surgical dischargE

Summary

The Descale Study aims to:

1. Look at the prescribing trends of opioids and the scale of long-term use following surgery within East Kent (United Kingdom)
2. Carry out a feasibility study to:

* see if clinical pharmacists can support patients following surgery to manage their post-surgical pain safely and prevent long-term opioid use
* calculate how much it costs the National Health Service (NHS)
* see how the patients experienced the intervention

For Aim 1, historic records of patients who have had surgery and were discharged on opioids will be reviewed. Data collected will include type and strength of pain-relieving medication prescribed; type of surgery; number of additional opioid prescriptions following discharge; use of medical services (e.g., General Practice appointments, physiotherapy); and patient demographics.

For Aim 2, clinical pharmacists will carry out early high-risk medication safety reviews to ensure that patients have their pain managed safely. Investigators will collect key data from patients receiving the clinical pharmacist intervention to see how it affected opioid use, costs and healthcare use. Patients who took part in the study will be invited to participate in an interview and will be asked what they know about opioids and the health risks, and their experiences of the intervention.

Conditions

• Opioid Dependence

Interventions

OTHER

Rapid Opioid de-escalation

Option 1: 10% - 50% decrease/day until opioids discontinued (≤ 10 days). For Fentanyl patches in decrements of 12 mcg/hr. Option 2: Stop all opioid medication completely

OTHER

Gradual Opioid de-escalation

Option 1: 20% - 50% decrease/weekly until opioids discontinued Option 2: 10% - 20% decrease/weekly until 30 mg daily. Then reduce by 5% - 10% everyday.

OTHER

Continuation of opioids

Continue on opioids and review in 1 weeks time.

Sponsors & Collaborators

• Kent Community Health NHS Foundation Trust

  collaborator UNKNOWN

• NHS Kent and Medway

  collaborator UNKNOWN

• University of Kent

  lead OTHER

Principal Investigators

• Dr Emma Veale · University of Kent

• Dr Johanna Theron · Kent Community Health NHS Foundation Trust

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-01-11

Primary Completion

2024-06-30

Completion

2024-09-30

Countries

• United Kingdom

Study Locations