Pain Management Options for Opioid-Tolerant Patients: A Randomized Controlled Trial

Pain is a fundamental symptom that drives healthcare use, including hospital readmissions and patients who are on high levels of opioids have particularly high utilization patterns, including hospital admissions and emergency department visits. Pain specialists may be able to improve these patients’ health and reduce healthcare costs. While pain management is actively studied for acute episodes, and for chronic-pain patients, sub-acute patients leaving the hospital after surgery have received relatively little prior research. Researchers are conducting a randomized evaluation of a new clinical pathway developed to provide pain management to these patients throughout the acute and into the sub-acute phases. The pathway includes a consultation in the hospital by a team of pain management specialists. Patients will have access to these specialists during the sub-acute phase after discharge. Improved pain management holds the potential to break the cycle of readmissions and escalating opioid use among these high-risk, high resource utilizing patients. In addition, the study provides a model of how to roll out care re-designs via random assignment to study their effectiveness in a rigorous way.