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Author Notes:

Correspondence: Mara.Schenker@emory.edu

MS is the Chief Investigator; she conceived the study, led the proposal and protocol development. NG, CWR, EO, AS, MS, LK, BB, JB, and JS contributed to the study design and development of the proposal. NG, JS, JB, and LK drafted the manuscript. All authors read and approved the final manuscript. All topics suggested for presentation will be circulated to Chief Investigator.

The authors declare that they have no competing interests.

Subjects:

Research Funding:

This study has undergone full external peer review as part of the funding process through the Injury Prevention Research Center at Emory (IPRCE). IPRCE supports research, education, and outreach to generate transformative changes that reduce the burden of injury in Georgia and the Southeast United States. This research will be supported, in part, by the University Research Committee of Emory University.

Keywords:

  • orthopedic trauma
  • life care specialist
  • opioid utilization
  • pain management
  • opioid use disorder
  • substance misuse
  • opioid epidemic
  • patient-reported outcomes

The effect of a Life Care Specialist on painmanagement and opioid-related outcomesamong patients with orthopedic trauma:study protocol for a randomized controlledtrial

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Journal Title:

Trials

Volume:

Volume 22

Publisher:

Type of Work:

Article | Final Publisher PDF

Abstract:

Background Orthopedic trauma patients face complex pain management needs and are frequently prescribed opioids, leaving them at-risk for prolonged opioid use. To date, post-trauma pain management research has placed little emphasis on individualized risk assessments for misuse and systematically implementing non-pharmacologic pain management strategies. Therefore, a community-academic partnership was formed to design a novel position in the healthcare field (Life Care Specialist (LCS)), who will educate patients on the risks of opioids, tapering usage, safe disposal practices, and harm reduction strategies. In addition, the LCS teaches patients behavior-based strategies for pain management, utilizing well-described techniques for coping and resilience. This study aims to determine the effects of LCS intervention on opioid utilization, pain control, and patient satisfaction in the aftermath of orthopedic trauma. Methods In total, 200 orthopedic trauma patients will be randomized to receive an intervention (LCS) or a standard-of-care control at an urban level 1 trauma center. All patients will be assessed with comprehensive social determinants of health and substance use surveys immediately after surgery (baseline). Follow-up assessments will be performed at 2, 6, and 12 weeks postoperatively, and will include pain medication utilization (morphine milligram equivalents), pain scores, and other substance use. In addition, overall patient wellness will be evaluated with objective actigraphy measures and patient-reported outcomes. Finally, a survey of patient understanding of risks of opioid use and misuse will be collected, to assess the influence of LCS opioid education. Discussion There is limited data on the role of individualized, multimodal, non-pharmacologic, behavioral-based pain management intervention in opioid-related risk-mitigation in high-risk populations, including the orthopedic trauma patients. The findings from this randomized controlled trial will provide scientific and clinical evidence on the efficacy and feasibility of the LCS intervention. Moreover, the final aim will provide early evidence into which patients benefit most from LCS intervention.

Copyright information:

© The Author(s). 2021

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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