2025/04/24 by Melissa B. Weimer, Michele Buonora, Alexandra M. Hajduk +5 · 1 voice
Medicine · #Opioid Use Disorder Treatment #Pain Management and Opioid Use #Pediatric Pain Management Techniques
paper · pdf · doi:10.1002/jhm.70066
openalex publication_date 2025/04/24 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
BACKGROUND: The management of analgesia in people hospitalized with chronic pain and elevated risk for opioid-related harm is challenging. While opioid stewardship programs could provide guidance, their feasibility in this population has not been examined. OBJECTIVES: To develop a case identification tool and evaluate the feasibility of an electronic medical record (EMR)-delivered opioid stewardship and pain intervention among hospitalized people with chronic pain and elevated risk for opioid-related harm. METHODS: After developing and evaluating the operating characteristics of a case identification tool to identify people with chronic pain and elevated risk for opioid-related harm, hospitalized adults with chronic pain and elevated risk for opioid-related harm were randomized to an EMR-delivered opioid stewardship and pain intervention versus usual care. Primary outcomes were feasibility-based. Exploratory outcomes were pain-related clinical outcomes. RESULTS: The case identification tool had a sensitivity of 88.9% and a specificity of 95.7%. The trial recruited 52/97 (54%) of potential participants who completed 52/52 (100%) potential assessments and of whom 45/52 (87%) were retained in the study at 4 weeks, demonstrating feasibility. On average, both treatment arms received 56% of the recommended guideline-concordant care and there was no significant difference in opioid and pain-related care in the two groups. CONCLUSION: It is both feasible to develop an EMR-based tool to prospectively identify hospitalized people with chronic pain and elevated risk for opioid-related harm as well as recruit these individuals to an EMR-delivered opioid stewardship and pain intervention. Additional strategies to support the provision of guideline-concordant care may be warranted.