Program for Reducing Opioid Use in Chronic Pain
(RECOUP Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to help people with chronic pain reduce their opioid use after surgery. The study tests the Transitional Pain Service Program (TPSP), which includes pain education, therapy, and a mobile app for managing pain. The goal is to find a safer way to handle pain and improve long-term health. Individuals who have used opioids for at least a month before surgery and can use the app might be suitable candidates for this trial.
As an unphased trial, this study offers a unique opportunity to explore innovative pain management strategies and potentially improve participants' quality of life.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it focuses on helping you reduce opioid use. If you're taking Methadone or Buprenorphine, you cannot participate in the trial.
What prior data suggests that the Transitional Pain Service Program (TPSP) is safe for managing chronic pain?
Previous studies have shown that the Transitional Pain Service Program (TPSP) reduces opioid use after surgery. Research indicates that this program helps patients manage pain more effectively and decrease their opioid dependence. Early data suggests that TPSP is well-tolerated, with no major side effects reported. Participants experienced a better quality of recovery, feeling better overall after surgery. This suggests the program is a safe and effective option for managing pain without heavy reliance on opioids.12345
Why are researchers excited about this trial?
Researchers are excited about the Transitional Pain Service Program (TPSP) because it offers a comprehensive, personalized approach to reducing opioid use in chronic pain patients after surgery. Unlike standard care, which typically involves follow-up with a surgeon and general pain management information, TPSP includes tailored follow-up appointments with a clinical psychologist and chronic pain specialist. This program also leverages technology through the Manage My Pain App, enabling patients to track their pain daily and receive detailed reports to guide their treatment. By integrating personalized care and technology, TPSP aims to empower patients to manage pain more effectively and potentially reduce reliance on opioids.
What evidence suggests that the Transitional Pain Service Program (TPSP) is effective for managing chronic pain?
Research has shown that the Transitional Pain Service Program (TPSP), available to participants in this trial, can significantly reduce opioid use after surgery. Studies have found that TPSP effectively links immediate post-surgery care with long-term recovery. The program combines pain education, therapy, and self-care tools. Evidence suggests it improves pain management and aids in safely reducing opioid use. In some cases, it even leads to better long-term outcomes by lowering the risk of persistent pain after surgery.13467
Who Is on the Research Team?
Hance Clarke, MD, PhD
Principal Investigator
Toronto General Hospital, University Health Network
Karim Ladha, MD
Principal Investigator
Toronto General Hospital, University Health Network
Elaheh Adly, MD
Principal Investigator
Hamilton Health Sciences Centre
Paul Tumber, MD
Principal Investigator
University Health Network, Toronto
Melanie Toman, MD
Principal Investigator
Thunder Bay Reginal Health Sciences Centre
Anton Marinov, MD
Principal Investigator
Rouge Valley Medical Centre
Duminda Wijeysundera, MD
Principal Investigator
Unity Health Toronto
Yuvaraj Kotteeswaran, MD
Principal Investigator
Thunder Bay Reginal Health Sciences Centre
Are You a Good Fit for This Trial?
This trial is for adults over 18 who have been using opioids for chronic pain at doses of 20-200 mg oral morphine equivalents daily for at least a month before surgery. Participants must understand English, not be in palliative care or organ transplantation, and not use Methadone/Buprenorphine.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive the Transitional Pain Service Program (TPSP) intervention, including pain education, Acceptance and Commitment Therapy (ACT), and use of the Manage My Pain (MMP) App.
Follow-up
Participants are monitored for safety and effectiveness after treatment, with an option to join the TPSP if still on opioids
What Are the Treatments Tested in This Trial?
Interventions
- Transitional Pain Service Program (TPSP)
Trial Overview
The study tests the Transitional Pain Service Program (TPSP) which includes pain education, Acceptance and Commitment Therapy (ACT), and an e-mobile tool to manage chronic pain post-surgery. The goal is to reduce opioid dependency while managing pain effectively.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Patients in the interventional group will be given a Transitional Pain Service follow-up appointment at the following postoperative time points (2 to 6 visits for the first two months, and then 1 to 2 visits on a monthly basis until one year). At each visit, patients will meet with the clinical psychologist and chronic pain specialist. Patients in the intervention group will have access to the Manage My Pain (MMP) App. which allows people living with pain to quickly and easily track their pain and function on a daily basis on their smartphones or a browser on their desktop or mobile device. One-page clinical reports will capture the changes in patients' outcome data between clinical visits over the course in time.Clinic visits can be offered in person at the hospital or over telehealth (video conference) based on the patient's preference and clinician's judgment for telehealth suitability.
Patients in the control group will receive standard care, which involves standard postoperative follow-up with their surgeon/primary care provider. Patients will also be sent with a link for an online multimedia tool during each follow-up time point that will provide information and education regarding non-pharmacologic techniques for managing pain. At the end, all patients in the control arm will be invited to join the TPSP after one year of follow-up if they are still taking opioids.
Find a Clinic Near You
Who Is Running the Clinical Trial?
University Health Network, Toronto
Lead Sponsor
Citations
Transitional Pain Services and Clinics: A Scoping Review of ...
Multiple lines of evidence suggest that such TPS/Cs models can significantly improve pain outcomes and facilitate successful opioid tapering. As ...
Transitional Pain Services: Closing the Gap Between Acute ...
Patients with CPSP use a disproportionate amount of healthcare resources, driving up costs and potentially leading to poor quality of life.
Transitional Pain Service: An Update - PMC - NIH
In most of these studies, the main outcome measured was the reduction in postoperative opioid use in surgical patients. In one of the first such ...
Transitional Pain Services and Clinics: A Scoping Review ...
Mostly, retrospective literature suggests that TPS/Cs can effectively bridge acute postoperative pain management with sustained long-term care, particularly for ...
The effectiveness of a transitional pain service in patients ...
Conclusions: TPS did not significantly affect short-term quality of recovery but might improve long-term outcomes , such as the incidence of ...
Patient Experiences and Clinical Outcomes in a ...
Siloed pain management across the perioperative period increases the risk of chronic opioid use and impedes postoperative recovery.
Patient Experiences and Clinical Outcomes in a ...
The objective of this study was to examine patients' experiences with and quality of recovery after participation in a TPS.
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