RT Journal Article
SR Electronic
T1 One-year opioid consumption trajectories among individuals receiving multidisciplinary postsurgical care: a single-center observational study from the Toronto General Hospital Transitional Pain Service
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP rapm-2024-105344
DO 10.1136/rapm-2024-105344
A1 Pagé, M Gabrielle
A1 Katz, Joel
A1 Darville, Rasheeda
A1 Gabriel, Gretchen
A1 Ladha, Karim S
A1 Huang, Alexander
A1 Ganty, Praveen
A1 Katznelson, Rita
A1 Tamir, Diana
A1 Fiorellino, Joseph
A1 Kahn, Michael
A1 Tao, Leeping
A1 Slepian, Maxwell
A1 Wieskopf, Jeffrey
A1 Clarke, Hance
YR 2024
UL http://rapm.bmj.com/content/early/2024/07/30/rapm-2024-105344.abstract
AB Introduction The Transitional Pain Service (TPS) is an innovative, personalized approach to postsurgical opioid consumption and pain management. The objectives of this study were to identify trajectories of opioid consumption and pain intensity within 12 months after initiating treatment through the TPS, identify biopsychosocial factors associated with trajectory membership, and examine the relationship between trajectory membership and other outcomes of interest over the same 12-month period.Methods Consecutive patients referred to the TPS were included in the present study (n=466). After providing informed consent, they completed self-report questionnaires at the initial visit at the TPS (either pre surgery or post surgery) and at every TPS visit until 12 months. Growth mixture modeling was used to derive trajectories and identify associated factors.Results Results showed three distinct opioid consumption trajectories for both presurgical opioid consumers and opioid-naïve patients. These trajectories all decreased over time and among those who were consuming opioids before surgery that returned to presurgical levels. Being man, having a substance use disorder, or reporting higher levels of pain interference were associated with higher daily opioid consumption for presurgical opioid consumers. For presurgical opioid-naïve individuals, higher opioid consumption trajectories were associated with higher levels of psychological distress. Five pain intensity trajectories were identified, and there were no significant association between opioid consumption and pain intensity trajectories.Conclusions Results suggest that opioid consumption and pain intensity trajectories mostly decrease after surgery in a high-risk population enrolled in a TPS. Results also show heterogeneity in postsurgical recovery and highlight the importance of using personalized interventions to optimize individual trajectories.No data are available. Data are available on reasonable request. No data are available for sharing as consent was not obtained from participants for this purpose.