About the project
Project title: Can a Pain And Coordination Plan (PAC-plan) in transition between hospital and primary care reduce opioid use and improve quality of life in patients after accidental injuries? A randomized controlled trial and a qualitative focus group study of participating GPs.
The study is a prospective register supported randomized controlled trial (R-RCT) designed to evaluate the effect of the PAC-plan. Patients will be recruited from the Division of orthopaedic surgery, Oslo University Hospital, Norway. In the qualitative sub-study, focus group interviews of participating GPs will be conducted to explore topics of relevance to the perceived practical usefulness and manageability of the intervention.
The PAC-plan includes a plan for discontinuation of opioids, an appointment settled with the GP before discharge and enhanced collaboration between hospital specialists and GPs.
Objectives
In this project we aim to reduce the proportion of opioid users and improve patient outcome after accidental trauma by implementing a Pain And Coordination plan (PAC-plan). In addition, we aim to explore the GPs experiences with the PAC-plan.
Background
Patients exposed to serious injuries are at risk of developing long-term opioid use. Many patients experience that return to normal everyday activities after trauma is difficult and feel left to themselves without a follow up plan and without a plan for systematic reduction of opioids. GPs often feel that they are not involved when patients are discharged from hospital and that follow-up and opioid management becomes difficult.
Opioids are useful in the acute phase after serious injuries, but it is important to focus on safe and appropriate pain management in the further phase. The opioid epidemic in the USA is a major national health crisis and has led to high mortality rates and social needs. In Norway, prescription of strong opioids is increasing.
Sub-projects
- Paper I: “The effect of a pain and coordination plan on opioid use in patients with accidental injuries 6 and 52 weeks after discharge. A register-supported randomized controlled trial.”
- Paper II: “The effect of a pain and coordination plan on pain and disability in patients after accidental injuries. A register-supported randomized controlled one-year follow-up trial.”
- Paper III: “A useful tool in the box? Participating GPs’ experiences and attitudes towards implementation of a pain and coordination plan in patients after accidental injuries. A qualitative focus group interview study. “
Financing
- Norwegian Research Fund for General Practice
- Oslo University Hospital, Norway
Cooperation
Ph.d. candidate, MD: Gunhild Nytrøen
Supervisors: Ph.d./ Associate professor Trygve Skonnord, professor Bård Natvig and ph.d. Holgeir Skjeie, Department of General Practice, Institute of Health and Society, University of Oslo. Ph.d. Lene B. Solberg, Division of orthopaedic surgery, Oslo University Hospital.
Others: Professor Leiv Arne Rosseland, Head of IPOT-project, Division of emergencies and Critical Care, Oslo University Hospital/Division of Critical Care, Institute of Clinical Medicine, University of Oslo. Professor Jon Michael Gran, Department of Biostatistics, Institute of Basic Medical Sciences , University of Oslo.
Project start and finish
01.08.2022-31.7.2028