Reducing Chronic Opioid Use in Veterans Undergoing Orthopedic Surgery Through a Telehealth Transitional Pain Service

What this Trial Is About

Researchers are evaluating a new approach called the Transitional Pain Service TPS to reduce chronic opioid use among Veterans undergoing orthopedic surgery through the VA Community Care Program. This study aims to determine if a telehealth version of TPS can safely manage pain and opioid use for Veterans receiving surgery outside VA Medical Centers. The study includes comparing opioid prescription patterns from non-VA providers to those from VA providers and understanding patient experiences with telehealth TPS. The TPS approach involves personalized pain management and nurse care coordination before, during, and for at least six months after surgery. Veterans at risk for chronic opioid use receive tailored plans that include education, non-drug therapies, and coordinated care transitions. Participants are randomly assigned to either telehealth TPS plus standard postoperative care or standard postoperative care alone. The study also involves interviews to identify factors that help or hinder opioid tapering after surgery. Participants will be monitored through telehealth visits and data collection on opioid use and pain outcomes for 90 days after surgery. Assessments include opioid dosage, pain intensity, pain interference, and care coordination measures. Researchers will also track opioid refills, tablets used, and timing of last opioid use. Follow-up includes visits with primary care providers to ensure continuity of care and evaluate the effectiveness of the telehealth program in reducing chronic opioid use.

VA Transitional Pain Service Study