Prevention of Chronic Postsurgical Pain in Chronic Opioid Users: (PRE-OPIOID)

Ransitional Teleconsultation to Prevent Chronic Postsurgical Pain in Chronic Opioid Users

Chronic opioid users undergoing surgery are at increased risk of CPSP, contributing to long-term disability, decreased quality of life, and prolonged opioid exposure. Existing preventive strategies remain limited, and early postoperative monitoring may represent a key opportunity for intervention. Evidence suggests that transitional pain services can improve outcomes by optimizing pain control and reducing long-term opioid consumption, but implementation is heterogeneous and often resource-intensive. Telemedicine offers a scalable alternative, enabling early specialized evaluation and timely therapeutic adjustments while maintaining accessibility. This randomized controlled trial will compare standard postoperative follow-up with standard follow-up plus a specialized teleconsultation performed between postoperative day 15 and 28. The intervention aims to detect insufficiently controlled pain, signs of neuropathic pain, or maladaptive opioid use, and to propose individualized therapeutic adjustments when required.

Participants will be followed for 6 months. Primary assessment will occur at 3 months to determine CPSP incidence. Secondary assessments will include pain trajectory (intensity, neuropathic features, functional interference), opioid consumption and misuse, quality of life, and a descriptive medico- economic evaluation

Study Overview

• Status: Recruiting
• Conditions: Postoperative Pain; Perioperative Medicine; Chronic Postsurgical Pain; Chronic Opioid Users; Transitional Pain Service
• Intervention / Treatment: Other: standard institutional perioperative management; Other: specialized teleconsultation

• Study Type: Interventional
• Enrollment (Estimated): 354
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Paul Tarpin, MD; Phone Number: 33+3.22.08.79.80; Email: Tarpin.paul@chu-amiens.fr

Study Locations

• France
  • Amiens, France, 80054
    • Recruiting
    • CHU Amiens-Picardie
    • Contact: Paul TARPIN, MD; Phone Number: 0322087980; Email: Tarpin.Paul@chu-amiens.fr
    • Sub-Investigator: Ottilie Fumery, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥18 years
• Elective non-urgent surgery with expected moderate or higher postoperative pain
• Chronic preoperative opioid use
• Written informed consent
• affiliated with a national social security scheme

Exclusion Criteria:

• Ambulatory surgery
• Endoscopic or palliative surgery
• Patients receiving opioid substitution therapy
• Non-medical opioid use
• Intrathecal/epidural analgesia or implanted neurostimulator
• Legally protected adults
• Severe psychiatric or neurodegenerative disorders

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Standard care + specialized postoperative teleconsultation	Other: standard institutional perioperative management; standard institutional perioperative management; Other: specialized teleconsultation; Patients in the intervention arm participate in a specialized teleconsultation between postoperative day 15-28 to detect poorly controlled pain, neuropathic features, or opioid-related concerns, and to adjust treatment if needed.
Active Comparator: Standard postoperative care alone	Other: standard institutional perioperative management; standard institutional perioperative management

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of chronic postsurgical pain (CPSP)	Incidence of chronic postsurgical pain (CPSP) at 3 months, defined as: new or aggravated postsurgical pain located at the surgical site or innervated territory,; persistent for ≥3 months,; intensity ≥3/10 (new pain) or increase ≥2/10 from baseline (aggravation),; with significant functional impact (≥3/10 on at least one Brief Pain Inventory interference item),; assessed at day 90 ±14.	at 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain trajectory	Pain trajectory is measured by using intensity (BPI), + neuropathic features (DN4) +Quality of life (EQ-5D-5L)	at 3 months
Pain trajectory	Pain trajectory is measured with intensity (BPI), neuropathic features (DN4), Quality of life (EQ-5D- 5L)	at 6 months
Opioid use	Opioid use is defined as oral morphine equivalent consumption, proportion with reduction/discontinuation, POMI-5F, SOWS, DSM-5 OUD criteria	at 3 months
Opioid use	Opioid use is defined as oral morphine equivalent consumption, proportion with reduction/discontinuation, POMI-5F, SOWS, DSM-5 OUD criteria	at 6 months
Descriptive medico-economic analysis	Descriptive medico-economic analysis is determined with assessment of direct and indirect costs, descriptive comparison of effectiveness (incidence of CPSP at 6 months),descriptive reporting of utility values derived from EQ-5D-5L at 6 months	at 6 months

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire, Amiens

Study record dates

Study Major Dates

• Study Start (Actual): January 14, 2026
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): January 1, 2029

Study Registration Dates

• First Submitted: July 9, 2026
• First Submitted That Met QC Criteria: July 16, 2026
• First Posted (Actual): July 21, 2026

Study Record Updates

• Last Update Posted (Actual): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 16, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: postoperative pain; Chronic postsurgical pain; perioperative medicine; transitional pain service; chronic opioid users
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative
• Other Study ID Numbers: PI2025_843_0191

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No