Transitional Pain Service for Postoperative Pain
(TPS-Select Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to determine if the Transitional Pain Service program can help surgical patients manage pain more effectively and reduce opioid use after surgery. Researchers seek to discover if this approach can prevent long-term pain and if a computer tool can better identify patients at risk. Participants will receive either their usual care or additional support, such as pain education and mental health resources, before and after surgery. This trial suits patients planning surgery at UCSF who are at higher risk for chronic pain afterward, as identified by a computer model. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants a chance to contribute to potentially groundbreaking pain management solutions.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that the Transitional Pain Service is safe for managing postoperative pain?
Research has shown that treatments in the Transitional Pain Service (TPS) are safe for patients. In previous studies, patients using TPS experienced less pain and required fewer strong painkillers 90 days after surgery. This indicates that the service effectively manages pain and is well-tolerated by patients.
In addition to TPS, psychological support and pain education are included in the treatment. Studies have found that educating patients about pain before surgery aids in recovery and pain management. This education is safe and carries no significant risks.
Overall, both TPS and psychological support have demonstrated positive results and are considered safe for surgical patients. Participants can rely on the safety of these treatments based on existing research.12345Why are researchers excited about this trial?
Researchers are excited about the Transitional Pain Service because it offers a comprehensive approach to managing postoperative pain, unlike the typical focus on medication alone. This service includes psychological management, pain education, and personalized support like mental health screenings and referrals, which are not standard in usual care. Additionally, it empowers patients to be actively involved in their recovery process by choosing the level of participation that suits them, potentially leading to better outcomes and patient satisfaction.
What evidence suggests that the Transitional Pain Service is effective for managing postoperative pain?
Studies have shown that the Transitional Pain Service (TPS), which participants in this trial may receive, can reduce the need for opioids after surgery and improve pain management. Specifically, nerve blocks in TPS significantly ease post-surgery pain and decrease opioid use. Research also indicates that pre-surgery education on pain management leads to less pain afterward. Patients who receive this education often report better pain control and use fewer opioids. Overall, TPS combines these methods to support better recovery and pain control after surgery.12678
Who Is on the Research Team?
Andrew Bishara, MD
Principal Investigator
UCSF Department of Anesthesia
Are You a Good Fit for This Trial?
This trial is for adult surgical patients at risk of developing long-term pain after surgery. It aims to see if a Transitional Pain Service (TPS) can prevent chronic pain and reduce opioid use post-surgery. Participants will be compared with those receiving usual care.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Pre-Surgery Support
Participants receive educational videos, meetings with a pain pharmacist, mental health screening, and physical therapy to prepare for surgery
Post-Surgery Support
Participants receive coordinated support including pain-relief procedures, medication management, and outpatient therapies to optimize recovery
Follow-up
Participants are monitored for pain levels, opioid use, and healthcare costs at 30, 60, and 90 days after discharge
What Are the Treatments Tested in This Trial?
Interventions
- Interventional Pain Procedures
- Psychological Management and Pain Education
Trial Overview
The study tests the effectiveness of TPS in managing postoperative pain versus usual care, using an AI algorithm to identify patients at high risk for persistent pain. The program includes pharmacologic management, psychological support, education, physical therapy, and interventional procedures.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Patients assigned to the Transitional Pain Service group will receive extra support before and after surgery to help with pain and recovery. This may include educational videos, meetings with a pain pharmacist for safe medication use and tapering, mental health screening with referrals to supportive resources, and physical therapy. Patients may also be offered pain-relief procedures or treatments such as nerve blocks, injections, imaging, or other outpatient therapies provided by pain specialists. These services are meant to support recovery, and patients may choose how much to participate while remaining in the study even if all activities are not completed.
In this arm, patients will receive usual surgical care. However, patients will still complete the questionnaires and will also have the option of a pharmacist wellness check-in at 60 days after surgery.
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of California, San Francisco
Lead Sponsor
Citations
Nerve Blocks for Post-Surgical Pain Management: A Narrative ...
Nerve blocks show great promise as effective alternatives for managing post-surgical pain. They can reduce the need for opioids and their side effects.
Transitional Pain Service: An Update - PMC - PubMed Central
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 ...
Clinical practice guidelines for postoperative pain ...
Effectiveness of peripheral nerve blocks for postoperative pain management, Recommendation 11: Peripheral nerve blocks are recommended as an essential ...
Study Details | NCT07296770 | An Artificial Intelligence ...
The goal of this clinical trial is to learn whether a pain-management program called a Transitional Pain Service can help prevent long-term ...
Full article: Interventional Pain Procedures: A Narrative ...
One RCT of ITDD demonstrated reduced pain, improved clinical success in pain control, significantly relieved common drug toxicities, and greater survival in ...
Ten years of transitional pain service research and practice
Analysis of the primary outcome showed that 90 days after surgery, TPS patients (13.4%) were significantly less likely to be taking opioids than the non-TPS ...
Transitional Pain Services: Closing the Gap Between Acute ...
Data from transitional pain services highlight that patients who are engaged in early intervention with acceptance and commitment training ...
Interventional Pain Procedures: A Narrative Review ...
Overall, the goal of interventional pain procedures is to improve the patient's quality of life and to provide effective pain management.
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