- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01883882
Pilot Trial of Opioid Taper Support (POTS)
Pilot Randomized Trial of Opioid Taper Support
The proposed research will develop, demonstrate the feasibility of, and pilot test in a randomized controlled trial a prescription opioid taper support intervention. This intervention aims to prevent opioid misuse and adverse events among patients receiving chronic opioid therapy for chronic non-cancer pain without evidence of current substance abuse.
The project will yield information essential to planning a future, larger-scale RCT designed to evaluate: 1) the efficacy of the intervention in preventing prescription opioid abuse, misuse, overdose and other adverse events among patients receiving chronic opioid therapy for chronic non-cancer pain, 2) the effects of the intervention on opioid use, pain, pain related activity interference, and mood. Participants in our pilot study will be limited to those without current opioid abuse or other substance abuse, but past substance abuse will be allowed. This will provide a sample of patients at risk for opioid abuse, misuse and overdose, but who may be able to taper their opioids successfully. Hypothesis: Patients receiving chronic opioid therapy for chronic non-cancer pain who are randomized to the opioid taper support intervention, as compared with patients randomized to usual opioid prescribing care, will have lower opioid average daily doses at 22 and 34 weeks.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Washington
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Seattle, Washington, United States, 98115
- University of Washington Center for Pain Relief
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- age 18-80 years;
- CNCP, defined as pain on more than half the days in the past six months, where indicated diagnostic workup is complete and treatment is focused on pain;
- currently on COT, defined as self-report of prescribed oral opioid medication use on a daily or near-daily (>90% of days) basis for 90 days or more;
- mean daily opioid dose in the past 30 days of 25 mg MED or greater;
- willing to participate in the study arm to which they are randomly assigned (including opioid taper in-person sessions if randomized to that group);
- able to read, speak, and write English.
Exclusion Criteria:
- currently receiving treatment for cancer (other than non-melanoma skin cancer);
- medical comorbidity with life expectancy less than a year (based on medical record review by the PI);
- recent use (past month) of parenteral, transdermal, or transmucosal opioids,
- currently residing in nursing home;
- currently using intrathecal pump for pain control;
- any current substance abuse according to the DSM-IV checklist (nicotine and marijuana will be allowed since Washington State allows medical marijuana for pain control);
- presence of illicit drug metabolite in baseline urine drug test,
- psychotic symptoms, psychiatric hospitalization or suicide attempts in the past year;
- current suicidal ideation with specific plan or intent;
- significant cognitive impairment (on 6-item screener Scale).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: taper support
Weekly visits with pharmacological and psychological support for opioid taper at 10% of original dose per week
|
Weekly visits with physician's assistant (supervised by pain physician/psychiatrist and pain psychologist) who provides pharmacological and psychological support for opioid taper at 10% per week
|
No Intervention: Usual care
Usual care for chronic pain.
All care allowed except buprenorphine.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
mean daily opioid dose over past week
Time Frame: week 22 after randomization
|
mean daily opioid dose over past week as calculated in morphine equivalent dose
|
week 22 after randomization
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
prescription opioid difficulties
Time Frame: week 22 after randomization
|
Prescription opioid difficulties subscale scores on: psychosocial problems and opioid control concerns
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week 22 after randomization
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 43641-B
- R34DA033384 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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