This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
The use of opioid medicines to treat long-term, or chronic, pain has risen rapidly during the past decade. These medicines can help patients manage chronic pain. However, overuse has led to a rise in addiction and deaths from overdose. Deaths from overdose of opioid medicines outnumber deaths from heroin and cocaine combined.
Doctors and patients don’t always talk about the risks and benefits of opioid medicines before choosing a treatment for pain. Studies show that patients and doctors may have different preferences for treating chronic pain. In this study, the research team is comparing two ways to help patients and doctors talk about the treatment choices. One way prompts doctors to talk with patients when treatments other than opioids might be effective. The other way educates patients about treatments for pain and encourages them to talk with their doctors about personal preferences.
Who can this research help?
Clinics can use findings from this study when considering ways to improve discussions between doctors and patients about managing and treating chronic pain.
What is the research team doing?
The study focuses on patients who have had at least a 30-day supply of opioid medicine, two or more opioid prescriptions, or a total of at least 700 morphine milligram equivalents at any one time within 90 days. The research team is enrolling up to 1,000 patients 18 years and older at Cedars-Sinai Medical Center in Los Angeles, California.
The research team is assigning primary care doctors, by chance, to use one of two methods to discuss treatment for chronic pain with patients.
Doctors in the first group get alerts through the electronic health record when they prescribe an opioid medicine for patients who meet certain criteria. The alerts are reminders about correct use of the medicines. Doctors can discuss other ways to treat pain if using opioids is one of several options.
Patients of doctors in the second group get education materials two days before each doctor’s visit. The materials help patients prepare for the visits. The materials also encourage patients to talk about their goals and preferences for treatment at the visits. Patients can choose to get the information via email, text message, or mail.
After each primary care doctor visit, patients answer a survey about their communication with their doctors. Patients also answer surveys monthly about how pain affects their lives and their ability to do daily activities such as walking, sitting, or climbing stairs.
The research team is comparing how the two methods affect patients’ pain, ability to do daily activities, and satisfaction with care. The team is also comparing the effect of each method on opioid prescriptions, depression, and patients’ satisfaction with their doctors. Last, the team is asking patients how useful the education materials are.
Patients with chronic pain, patient advocacy groups, and doctors are working with the research team to design and carry out the study.
Research methods at a glance
- Penney Cowan, Founder & CEO, American Chronic Pain Association
- Tom Norris, Chronic Pain Patient & Chronic Pain Patient Advocate
Other Stakeholder Partners
- Consumer Reports Health
- ABIM Foundation