Optimal Management of Pain in Hospitalized Patients - Opioid Tolerant Populations.

Duke University

Status: Terminated

Conditions: Postoperative Pain; Acute Pain; Pain

Treatments: Other: New Clinical Pathway

Study type: Interventional

Funder types: Other

Identifiers

NCT02470728

Pro00076402

Details and patient eligibility

About

Pain is a symptom that drives hospital admissions, and pain management is required by most patients during their hospital stay. Further, the use of medications such as opioids can lead to upward-spiraling doses, especially among chronic pain patients whose resource utilization rates are high. Many initiatives aim to reduce the costs of these "high-resource utilizing" patients. One exciting aspect of improving the management of pain is that this may help prevent patients from ever becoming high-cost in the first place. The purpose of this study is to examine the impacts of an early and sustained intervention pathway, in comparison to the current standard of care, for the treatment of pain in opioid tolerant patients. It is hypothesized that patients randomized to the intervention pathway, in comparison to the control, will lead to decreased costs of care, a reduction in opioid usage within 3 and 6 months, and decrease in hospital readmission rates.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (18 years and older)
• Known opioid tolerant (as determined per FDA criteria)
• Agree to sign the informed consent and HIPAA forms

Exclusion criteria

• Patients under the age of 18 years
• No known opioid tolerance
• Do not agree to sign the informed consent and HIPAA forms

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Control Group

No Intervention group

Description:

Those randomized into the control group will receive the current standard of care for pain management. This standard care pathway involves a pain management specialist consultation only at the request of the primary admitting team. The pain management consultation can occur at any time during the patient's inpatient stay and care by these specialists ends at discharge.

Treatment Group

Experimental group

Description:

Subjects randomized into the treatment (early intervention) group will receive the New Clinical Pathway: pain management care coordinated by pain-management specialists from inpatient admission through 60 days after discharge.

Treatment:

Other: New Clinical Pathway