The Nonpharmacologic Options in Postoperative Hospital-Based and Rehabilitation Pain Management (NOHARM) trial has begun enrollment of study participants. The trial is among the first of the NIH Collaboratory’s Demonstration Projects to be supported through the NIH Heal Initiative’s PRISM program.

Congratulations to co–principal investigators Drs. Andrea Cheville and Jon Tilburt and the NOHARM team!

The PRISM projects—Pragmatic and Implementation Studies for the Management of Pain to Reduce Opioid Prescribing—are studying the real-world effectiveness of nonpharmacologic interventions for pain and assessing the implementation of these interventions to improve pain management and reduce reliance on opioids. The NIH Collaboratory Coordinating Center serves as the PRISM Resource Coordinating Center.

NOHARM is a stepped-wedge, cluster randomized pragmatic trial testing a bundled intervention comprised of patient- and clinician-facing decision support embedded in the electronic health record (EHR). The purpose of the intervention is to elicit preferences for, document, and direct patients toward evidence-based nonpharmacologic postoperative pain care. The trial will enroll up to 140,000 patients in surgical practices in 4 healthcare systems to evaluate whether pain and function, assessed with PROMIS tools, can be improved while honoring patient values and deemphasizing opioids in pain management.

During the 1-year planning phase, the study team recruited study sites and assessed the feasibility of the EHR-embedded bundle of decision support components. Learn more about NOHARM in this interview with Dr. Cheville.

NOHARM is supported by the NIH through the NIH HEAL Initiative under an award from the National Institute on Aging.