Recruiting

Observational Study

Sponsor:

VA Office of Research and Development

Code:

NCT06223503

Conditions

Chronic Opioid Use

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Transitional Pain Service

Study Details

Brief summary:

The VA Community Care Program has provided an important resource to improve access to surgical care for Veterans unable to have treatment at VA Medical Centers (VAMC). However, there is an increased risk of developing chronic opioid use when at-risk surgical patients receive opioids from non-VA providers. A multidisciplinary approach to perioperative pain management known as the Transitional Pain Service (TPS) has been shown to effectively reduce chronic opioid use among Veterans after surgery, but it is unknown whether it can be used to achieve the same outcomes for Veterans using Community Care for high-risk surgery. Through this project, the investigators will generate important data to establish whether a telehealth TPS approach can serve as a scalable and effective strategy to ensure safe opioid use among Veterans undergoing orthopedic surgery. The investigators will randomize Veterans using Community Care for orthopedic surgery to telehealth TPS versus standard of care. Finally, the investigators will interview patients using Community Care to better understand barriers and facilitators to telehealth TPS and Veteran satisfaction with the approach to pain management.

Conditions

Chronic Opioid Use

Study ID

NCT06223503

Start date

Mar 1, 2024

Status verified date

Apr, 2026

Completion date

Jul 1, 2027

Anticipated

Primary completion date

Mar 1, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

Aims 1 \& 3:

  • The investigators will include Veterans who are referred to the Veteran Community Care Program (VCCP) for an orthopedic surgery procedure from any VA medical center throughout VISN-19.
  • Additionally, these Veterans must be 18+ years of age who are not on chronic opioids at the time of surgery, and who have a VA primary care provider (PCP).

Aim 2:

  • Veterans who received TPS (Aim 1) and referring VA Primary Care Providers.

Exclusion Criteria:

Aim 1:

  • The investigators will exclude Veterans who are scheduled for other types of surgical procedures, are on chronic opioid therapy before surgery, are on hospice or end-of-life care, are cognitively impaired, or unable to complete the follow-up visits for any other reason.

Aim 2:

  • The investigators will exclude Veterans not randomized to the TPS Telehealth intervention of Aim 1.

  • Primary Care Providers will be excluded if they do not primarily work at the VA.

Aim 3:

  • The investigators will exclude Veterans who were not randomized to the TPS Telehealth intervention.
  • Veterans who experienced a major complication during the perioperative period or experienced an extended length of stay (LOS) based on exceeding the upper interquartile range of median LOS.
  • Exclusion criteria for this aim also include patients on hospice care, individuals discharged to a care facility, and those with scheduled readmissions for follow up procedure(s) within 90-days.

Study Design

Enrollment

400 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Prevention

Interventions and Outcome Measures

Arms

experimental: Telehealth Transitional Pain Service + Standard Postoperative Follow-Up Care

Telehealth Transitional Pain Service + Standard Postoperative Follow-Up Care

active comparator: Standard Follow Up Care

Standard Follow Up Care

Interventions

Transitional Pain Service

The Transitional Pain Service (TPS) is a novel perioperative surgical home approach that consists of comprehensive pain management and care coordination before, during and for at least 6-months after surgery for Veterans at risk for chronic opioid use (COU).

Primary outcome measure

  • Persistent post-surgical opioid use [ Time Frame: 90 days after surgery ]

Central Contacts and Locations

Central contacts

Benjamin S Brooke, MD PhD

(801) 582-1565Benjamin.Brooke@hsc.utah.edu

Julie L Hales

(801) 582-1565julie.hales@va.gov

Locations

VA Salt Lake City Health Care System, Salt Lake City, UT

Recruiting

Salt Lake City, Utah, United States, 84148-0001

Contacts

Amyanne Wuthrich, MS BS

(801) 582-1565Amyanne.Wuthrich@va.gov

Lisa A O'Hara

(801) 582-1565lisa.o'hara@va.gov

Principal Investigator:

Benjamin S Brooke, MD PhD

More Information

Sponsor

VA Office of Research and Development

Last update posted

May 6, 2026

Last verified

Apr, 2026

Keywords

  • Post-operative pain
  • Opioid use disorder
  • Opioid misuse
  • MISSION Act
  • Community Care
  • Transitional Care Coordination

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by VA Office of Research and Development on 2026-05-06.