Virtual transitional pain service delivered via telehealth is effective in preventing new and persistent opioid use amongst post-surgical spine patients.

Autor:	Hussain M; Lucid Lane, Inc., Norgeot B; Lucid Lane, Inc., Zaafran A; Lucid Lane, Inc., Stark J; University of Texas Health Sciences Center, McGovern Medical School., Caridi J; University of Texas Health Sciences Center, McGovern Medical School., Fenoy A; Northwell Health Feinstein Institutes for Medical Research, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell., Pivalizza E; University of Texas Health Sciences Center, McGovern Medical School.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2023 Aug 20. Date of Electronic Publication: 2023 Aug 20.
DOI:	10.1101/2023.08.18.23294272
Abstrakt:	Opioid dependence is a national crisis, with 30 million patients annually at risk of becoming persistent opioid users after receiving opioids for post-surgical pain management. Translational Pain Services (TPS) demonstrate effectiveness for behavioral health improvements but its effectiveness in preventing persistent opioid use is less established, especially amongst opioid exposed patients. Prohibitive costs and accessibility challenges have hindered TPS program adoption. To address these limitations, we designed and implemented a remote telehealth TPS protocol focusing on preventing continued opioid use while improving behavioral health. Licensed therapists trained in the opioid-tapering CBT protocol delivered sessions reimbursed through standard payer reimbursement. Our prospective study evaluated the protocol's effectiveness on preventing persistent opioid use and behavioral health outcomes amongst both opioid naïve and exposed patients. In an opioid-naive patient cohort (n=67), 100% completely tapered off opioids, while in an opioid-exposed cohort (n =19) 52% completely tapered off opioids, demonstrating promising results. In both cohorts, we observed significant improvements in behavioral health scores, including pain. This opioid-tapering digital TPS is effective, adoptable, and incurs no out-of-pocket cost for healthcare systems. We provide the opioid-tapering CBT protocol in the supplement to facilitate adoption. Trial Registration Impact of Daily, Digital and Behavioral Tele-health Tapering Program for Perioperative Surgical Patients Exposed to Opioids and Benzodiazepines registered at clinicaltrials.gov, NCT04787692. https://clinicaltrials.gov/ct2/show/NCT04787692?term=NCT04787692&draw=2&rank=1. Competing Interests: Competing Interests Statement MH is a salaried employee of Lucid Lane, Inc., has stock options in Lucid Lane, Inc., and has received conference travel support from Lucid Lane, Inc. BN is a salaried employee of Lucid Lane, Inc. and Anthem, Inc., has stock options in Lucid Lane, Inc. and Anthem, Inc., and has patents planned from Lucid Lane, Inc. and Anthem, Inc. AZ is a salaried employee of Lucid Lane, Inc., and Lucid Lane Providers, P.C., has received travel support from Lucid Lane, Inc., is on the leadership board of Lucid Lane and Board of Directors, and is on the Advisory Board of the American Festival for Thy Arts. JS has no competing interests. JC has received teaching payment from Stryker Spine. AF has grant support from NIH NINDS R01 #NS113893, and participates on the Data Safety Monitoring Board/Advisory Board of Medtronic. EP served as President for the Texas Society of Anesthesiologists, and serves as a Medical Consultant with future stock options at Lucid Lane, Inc.
Databáze:	MEDLINE
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