Reducing Opioid Use for Chronic Pain Patients Following Surgery

2018-09-24 06:23:25 | BioPortfolio


Patients with chronic pain are often prescribed long-term opioid therapy, despite the serious risks and growing concerns related to opioid use. The Toronto General Hospital has created the world's first multidisciplinary perioperative Transitional Pain Service Program (TPSP) aimed at reducing the incidence and severity of chronic post-surgical pain. The TPSP incorporates a variety of mechanisms and interventions to help patients manage pain and to wean off opioids. The approach consists of: pain education, Acceptance and Commitment Therapy (ACT), and an e-mobile self- management tool to help patients manage chronic pain more effectively. With the TPSP team, the investigators hope to continually assist patients to achieve a balance between the benefits and potential harms of opioid use to promote long-term health and well-being.


The proposed research program encompasses several study designs to evaluate the effectiveness and potential implementation of the TPSP across Ontario. The investigators will use three approaches to create a comprehensive evidence-base that can be used to guide future policy and programs related to the management of surgical patients with complex pain and chronic opioid use. In the first phase, a multicenter randomized controlled trial will be conducted in 5 hospital sites to evaluate the effectiveness and potential implementation of TPSP across Ontario. The aim is to recruit a total of 210 patients who are currently taking opioids and also undergoing a surgical intervention (e.g., spinal fusion, hip or knee arthroplasty, major cardiac surgery, hysterectomy, colectomy, cholecystectomy, major vascular surgery, hernia repairs, bariatric surgery, and thyroidectomies). The randomized controlled trial will determine the effectiveness of the TPSP at weaning patients completely off opioids while still managing pain after one year. Secondly, an economic and healthcare utilization analysis of the program via linkage to provincial administrative databases will be carried out to understand the impact the TPSP program has on the healthcare system as a whole. Lastly, a qualitative study will be conducted on both the treatment and control groups. The investigators hope to capture further insight to understand patients and providers experiences of the TPSP intervention.

Study Design


Chronic Pain


Interventional Group, Control Intervention


Toronto General Hospital- University Health Network
M5G 2N2


Not yet recruiting


University Health Network, Toronto

Results (where available)

View Results


Published on BioPortfolio: 2018-09-24T06:23:25-0400

Clinical Trials [9258 Associated Clinical Trials listed on BioPortfolio]

Evaluating the Effectiveness of an ACT-Based Bibliotherapy Intervention Among Adults Living With Chronic Pain

Chronic pain has a significant impact on the physical and psychological functioning of those living with this condition. It is now recognized that Acceptance and Commitment Therapy (ACT) i...

Yoga and Occupational Therapy to Improve Pain

This was a randomized control trial of a yoga and self-management intervention for individuals with chronic pain. Participants were assigned to either a wait-list control group (self-manag...

Virtual Reality as an Adjunctive Measure for Pain Control in Cancer Survivors

This study seeks to explore the efficacy of virtual reality (VR) as a practical adjunctive therapeutic intervention in the self management of the chronic pain associated with cancer surviv...

Functional Exercises for Chronic Low Back Pain

Non-specific low back pain is a common condition. Exercise is effective treatment for chronic low back pain. We hypothesized the functional exercise group will present pain reduction and f...

Hypnosis as a Treatment of Chronic Widespread Pain in General Practice. A Pilot Study.

Objective: The study was performed to evaluate the effect of a standardized hypnosis treatment used in general practice for patients with chronic widespread pain (CWP). Design: A randomiz...

PubMed Articles [26349 Associated PubMed Articles listed on BioPortfolio]

Group pain neuroscience education and dance in institutionalized older adults with chronic pain: a case series study.

: The use of pain neuroscience education in older adults has seldom been reported. While this age group shows high rates of chronic pain prevalence, its characteristics may also challenge an intervent...

Efficacy of Interpretation Bias Modification in Patients with Chronic Pain.

Patients with chronic pain demonstrate interpretational bias to pain and models of pain suggest interpretational bias affects subsequent pain experience. This study developed an interpretation bias mo...

Novel insights into stroke pain beliefs and perceptions.

: Chronic pain is common following stroke, yet its characteristics are poorly understood.: To characterize the beliefs and perceptions of people with stroke who experience chronic pain and compare the...

Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT).

One-size-fits-all interventions reduce chronic low back pain (CLBP) a small amount. An individualised intervention called cognitive functional therapy (CFT) was superior for CLBP compared with manual ...

Reducing the Hypertensive Effects of the Prolonged Surgical Tourniquet Using a Dual-Cuff Strategy: A Prospective Randomized Controlled Trial.

We evaluated whether moving the "line of crush" from thigh to the calf before onset of tourniquet-mediated hypertension would prevent or diminish it. We also evaluated any change in pain or functional...

Medical and Biotech [MESH] Definitions

A study in which observations are made before and after an intervention, both in a group that receives the intervention and in a control group that does not.

Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY.

Groups that serve as a standard for comparison in experimental studies. They are similar in relevant characteristics to the experimental group but do not receive the experimental intervention.

Works about a study where participants are assigned to a treatment, procedure, or intervention by methods that are not random. Non-randomized clinical trials are sometimes referred to as quasi-experimental clinical trials or non-equivalent control group designs.

Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions.

More From BioPortfolio on "Reducing Opioid Use for Chronic Pain Patients Following Surgery"

Quick Search

Relevant Topics

An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...

Pain is defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Some illnesses can be excruci...

Surgical treatments
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...

Searches Linking to this Trial