Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
基本信息
- 批准号:10210513
- 负责人:
- 金额:$ 152.13万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-09-30 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdoptionAmericanAmputationBundlingCaringCesarean sectionChronicClinicalCluster randomized trialColorectal SurgeryComplexConduction AnesthesiaConsumptionData CollectionData ElementDependenceDisciplineDiseaseEducationEnsureEvaluationExerciseGoalsGuidelinesGynecologic Surgical ProceduresHealth systemHealthcare SystemsHospitalsInstitutionInterventionJointsLeadLower ExtremityMethodsModalityModelingMonitorNarcoticsOperative Surgical ProceduresOpioidOutcomeOverdosePainPain managementParentsPatient PreferencesPatientsPerioperativePerioperative CarePoliciesPopulationPostoperative PainPostoperative PeriodPragmatic clinical trialProceduresPublic HealthQuality of lifeReplacement ArthroplastyReportingResearchResortRiskRoleSiteSpecific qualifier valueSymptomsSystemTestingTouch sensationVendorWorkaddictionbasebody-mindcare deliverychronic painclinical decision supportcohortdesigndisabilitydiscrete datadisparity reductioneffective interventionevidence basehealth care modelhealth care service organizationhigh riskimplementation researchimplementation strategyimprovedmultimodalitynon-opioid analgesicnovelopioid epidemicopioid misuseopioid useopioid userpain reductionpain rehabilitationpain reliefpatient orientedpreferenceprescription opioidpreservationrisk benefit ratiosafe patientsatisfactionsupport toolssurgery outcometrenduptake
项目摘要
ABSTRACT
Prescriptions for narcotic pain relief after surgery result in unintended prolonged opioid use for
hundreds of thousands of Americans. That trend fuels an excess supply of opioids that can
lead to dependence, addiction, diversion, and overdoses on a national scale. Non-
pharmacological pain care is effective and recommended by guidelines for perioperative pain
while offering a more favorable risk benefit ratio. However, nonpharmacological pain care is
rarely used as first or second-line therapy after surgery. Patient and clinician decision support
interventions are effective in encouraging patient centered and guideline-concordant care, but
these strategies have not been tested pragmatically as a bundle in every day postoperative pain
care. The NOHARM trial will first confirmed the feasibility of patient-facing as well as clinician-
facing decision support components of an EHR-imbedded evidence-based bundle (Aim 1).
Then we will test our bundle in a step-wedge, cluster randomized trial at 18 sites in 4 Health
Systems (Aim 2) affiliated with one national healthcare organization that uses a common EHR
platform. We will test a sustainable system strategy that could change the paradigm of
perioperative pain management toward nonpharmacological options in a manner that preserves
patient function, honors patient values and maintains availability of opioids as a last resort. This
could serve as a model for healthcare organizations nationally and could be disseminated
through our institution’s ongoing partnership with the largest national EHR vendor. To ensure
our approach is sustainable, we will also study what worked and what did not at all study sites
(Aim 3), focusing on high-risk patients within a parent organization that has expressed a high-
level commitment to addressing the opioid crisis.
摘要
手术后麻醉镇痛处方导致阿片类药物非预期长期使用,
成千上万的美国人。这一趋势助长了阿片类药物的过度供应,
在全国范围内导致依赖、成瘾、转移和过量。非
药物疼痛护理是有效的,并建议围手术期疼痛指南
同时提供更有利的风险收益比。然而,非药物性疼痛护理是
很少用作手术后的一线或二线治疗。患者和临床医生决策支持
干预措施在鼓励以患者为中心和与指南一致的护理方面是有效的,但
这些策略还没有在每天的术后疼痛中作为一个捆绑包进行实际测试
在乎NOHARM试验将首先确认面向患者以及临床医生的可行性,
面向EHR嵌入的循证包(目标1)的决策支持组件。
然后,我们将在4个健康中心的18个地点进行一项逐步楔形分组随机试验,
系统(目标2)附属于一个使用通用EHR的国家医疗保健组织
平台我们将测试一种可持续的系统战略,
围手术期疼痛管理向非药物选择的方式,
病人的功能,尊重病人的价值观,并保持阿片类药物作为最后手段的可用性。这
可以作为全国医疗机构的典范,
通过我们机构与最大的全国EHR供应商的持续合作伙伴关系。确保
我们的方法是可持续的,我们还将研究在所有研究地点什么有效,什么无效。
(Aim 3),重点关注母组织内的高风险患者,这些患者表达了高-
致力于解决阿片类药物危机。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Andrea Lynne Cheville其他文献
Andrea Lynne Cheville的其他文献
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{{ truncateString('Andrea Lynne Cheville', 18)}}的其他基金
Achieving Equity through SocioCulturally-informed, Digitally-Enabled Cancer Pain managemeNT” (ASCENT) Clinical Trial
通过社会文化知情、数字化的癌症疼痛管理 NT™ (ASCENT) 临床试验实现公平
- 批准号:
10539159 - 财政年份:2022
- 资助金额:
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HoPe 项目:利用 PROM、AI 和 EHR 使住院患者出院回家
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10675460 - 财政年份:2022
- 资助金额:
$ 152.13万 - 项目类别:
Project HoPe: Achieving Home Discharge for institutionally-bound Patients with PROMs, AI, and the EHR
HoPe 项目:利用 PROM、AI 和 EHR 使住院患者出院回家
- 批准号:
10456362 - 财政年份:2022
- 资助金额:
$ 152.13万 - 项目类别:
Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
- 批准号:
10468778 - 财政年份:2019
- 资助金额:
$ 152.13万 - 项目类别:
Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
- 批准号:
10263299 - 财政年份:2019
- 资助金额:
$ 152.13万 - 项目类别:
Computerized Adaptive Testing to Direct Delivery of Hospital-Based Rehabilitation
计算机化自适应测试直接提供医院康复服务
- 批准号:
9229048 - 财政年份:2015
- 资助金额:
$ 152.13万 - 项目类别:
Computerized Adaptive Testing to Direct Delivery of Hospital-Based Rehabilitation
计算机化自适应测试直接提供医院康复服务
- 批准号:
9045667 - 财政年份:2015
- 资助金额:
$ 152.13万 - 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
保持癌症表现的协作护理 (COPE) 试验
- 批准号:
8434848 - 财政年份:2012
- 资助金额:
$ 152.13万 - 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
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- 批准号:
8625279 - 财政年份:2012
- 资助金额:
$ 152.13万 - 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
保持癌症表现的协作护理 (COPE) 试验
- 批准号:
8816053 - 财政年份:2012
- 资助金额:
$ 152.13万 - 项目类别:
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