Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework.
Sandra M Eldridge, Gillian A Lancaster, Michael J Campbell...
https://pubmed.ncbi.nlm.nih.gov/26978655/Actively Recruiting
Led by The Cleveland Clinic · Updated on 2025-12-17
120
Participants Needed
1
Research Sites
52 weeks
Total Duration
This research aims to evaluate the feasibility and safety of using oral methadone after spine surgery to reduce long-term opioid use. Researchers are conducting a randomized, triple-blinded, placebo-controlled pilot trial called the MEND trial to gather early data on methadones effects on opioid use three months after surgery. The study addresses the significant issue of opioid dependence following spine surgery, which carries high risks of prolonged opioid use and related complications. Participants are assigned to one of two groups one receiving oral methadone and the other a placebo. Patients in the methadone group will take 5 mg twice daily on the first two postoperative days, then 5 mg once daily on days 3 through 5. Those in the placebo group will receive placebo doses on the same schedule. Patients who were using opioids before surgery will return to their usual opioid regimen after surgery. The study monitors the impact of this treatment during the postoperative period. Throughout the study, participants willingness to join, provider engagement, protocol adherence, and follow-up completion will be assessed at various time points up to 90 days after surgery. Researchers will also track cardiac rhythm abnormalities and respiratory adverse events for up to 18 months. The main goal is to estimate the reduction in opioid use three months post-surgery. Participants will undergo regular assessments and monitoring to collect these data during the trial period, which may last up to several years.
CONDITIONS
Methadone to Reduce Chronic Opioid Use After Major Spine Surgery: The MEND Pilot Feasibility Study
S
Stephanie Stoianoff, MBA
S
Sandra Durbin, CLPN, CCRP
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The Cleveland Clinic
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Blinded Methadone (Post-op Days 1–5) | Blinded Placebo (Post-op Days 1–5) |
|---|---|---|
| What it is | Oral methadone given in a blinded manner for 5 days after surgery, with dosing scheduled twice daily for the first two days and once daily for the next three days. | Oral placebo provided in a blinded manner for 5 days after surgery, matching the methadone schedule. Patients with prior opioid use resume their preoperative opioid regimen after surgery. |
| Role in trial | Tested to determine whether oral methadone can reduce chronic opioid use and improve postoperative pain management. | Serves as the blinded comparator for feasibility, opioid use reduction, pain outcomes, and safety assessments. |
| Primary Use | Investigational use of oral methadone for acute postoperative analgesia and possible reduction in persistent opioid use after major spine fusion. | Matched schedule as blinded comparator for evaluating feasibility and opioid reduction in the trial setting. |
| How it is given or performed | Methadone is given orally, twice daily on days 1 and 2, then once daily on days 3–5 post-surgery, while blinding is maintained throughout. | Placebo is administered orally using the same schedule as methadone, under blinded conditions. |
| Evidence status | Prior studies indicate intraoperative methadone reduces postoperative pain and opioid consumption for spine surgery. Additional research is ongoing to confirm sustained reductions in chronic opioid use after surgery. | Placebo does not provide active pharmacological pain relief. Used as a control in clinical trials to measure effects of investigational interventions. |
| Important limitations | The current trial is a pilot feasibility study, meaning it is not powered for definitive clinical efficacy or safety results. Possible methadone-specific risks, like cardiac rhythm changes or respiratory events, are monitored and require further large-scale study for full assessment. | Placebo-controlled pilot studies help measure feasibility but do not provide clinically active pain relief. Outcomes related to long-term opioid use and complications await more definitive large-scale research. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Day of surgery through postoperative day 1
Participants undergo major spine surgery followed by immediate post-operative care.
1 hospitalization period including surgery and immediate recovery
Duration - 5 days post-surgery
Participants receive either methadone or placebo medication postoperatively: 5 mg twice daily on days 1 and 2, then 5 mg once daily on days 3 through 5.
Daily medication administration during hospitalization and post-op days 1 to 5
Duration - Up to 3 months post-surgery
Participants are monitored for safety, opioid use, and recovery outcomes after completing the treatment period.
Follow-up visits and assessments over 90 days
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
OTHER
Number of Arms
2
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Lead Sponsor