In light of the current opioid epidemic, there is an urgent need to address chronic opioid use prior to surgery before it is exacerbated by postoperative surgical pain. Our central hypothesis is that patients who taper their opioid use prior to surgery will have reduced postoperative opioid and pain medication usage, less postoperative pain, and improved patient reported outcomes relative to patients that do not taper prior to surgery. Our specific aims include: 1. Determine whether reducing patients' preoperative opioid usage through a structured tapering regimen reduces postoperative opioid and pain medication use. 2. Examine whether reducing patients' preoperative opioid usage through a structured tapering regimen reduces postoperative pain. 3. Determine whether reducing patients' preoperative opioid usage through a structured tapering regimen improves patient reported outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
16
Guided weekly opioid pain medication reduction via telephone calls prior to elective spinal fusion surgery.
Weekly phone calls prior to elective spinal fusion surgery, without opioid pain medication reduction recommendation or guidance.
Stanford Hospital and Clinics
Redwood City, California, United States
Change in Postoperative Opioid Pain Medication Dose
Weekly average opioid medication use in morphine equivalent dosage (MED)
Time frame: Weekly, month 3, month 6
Change in Numeric Pain Scale Score
Generic measure of average back pain, scale 0-10 with 0 being no pain and 10 being the most pain experienced.
Time frame: Weekly, month 3, month 6
Change from baseline Patient Reported Outcome Measures (PROMs)
PROMIS computer adaptive testing: global health, physical function, pain interference, pain behavior, depression, anxiety, fatigue, sleep disturbance, and satisfaction with social roles and activities.
Time frame: Weekly, month 3, month 6
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