PP314 – Transitional Pain Service A Novel Approach to Perioperative Pain Management
The mission of the Transitional Pain Service (TPS) is to reduce suffering from pain and improve functional recovery after surgery through multidisciplinary, coordinated care beginning before surgery, during the hospital stay, and continuing after patients are discharged from the hospital. TPS has an additional mission to prevent the development of new chronic opioid use after surgery and to help patients who already use chronic opioids to taper and completely transition off all opioids during their recovery from surgery. We continue to work closely with patients for at least 6 months after surgery to assist with pain management, care coordination, and opioid taper and cessation and then provide a warm handoff to the primary care providers to ensure excellent continuity of care.
During 2018, we enrolled 222 patients. Of those patients 28% used chronic opioids prior to surgery. After surgery, we assisted 43% of those patients to completely stop opioid use and 37% of them to decrease their opioid dose by an average of more than 50%. Of the 72% of patients who did not use chronic opioid therapy prior to surgery, 0% were still on opioids by three months after surgery. This outcome compares favorably to rates of 5-12% new chronic opioid use reported in the literature and 6% in our own historical control group.
To date, the TPS service has only been available to serve patients having surgery at the Salt Lake City VA hospital.