Speakers
Jon Tilburt, MD
Professor of Medicine and Biomedical Ethics
Mayo Clinic
Andrea Cheville, MD
Professor of Physical Medicine and Rehabilitation
Mayo Clinic
Topic
Learning While Sprinting: A One-Year Retrospective from the NOHARM Pragmatic Trial
Keywords
PRISM; NIH Heal Initiative; NOHARM; Postoperative care; Nonpharmacologic pain care (NPPC); Stepped wedge; Cluster-randomized trial; Electronic health records (EHRs); Patient engagement; Clinical decision support
Key Points
- The Nonpharmacologic Options in Postoperative Hospital-based and Rehabilitation Pain Management (NOHARM) NIH Collaboratory Trial is completing its pilot phase. This embedded, stepped-wedge PCT will test a sustainable strategy in perioperative, nonpharmacologic pain management that preserves patient function, honors patient values, and maintains the availability of opioids as a last resort.
- NOHARM is a pragmatic, EHR-integrated intervention that bundles a portal-based conversation guide that captures patient preferences for postsurgical pain care and a clinician-directed decision support tool.
- Nonpharmacologic pain care management options include walking, yoga, tai chi, acupressure, massage, meditation, and relaxation.
Discussion Themes
Opioids are insufficient in postsurgical care. Guidelines recommend nonpharmacologic pain care (NPPC), but there have not been studies showing how to make NPPC more viable.
The COVID-19 pandemic caused disruption in scheduled surgeries and also air travel, which precluded on-the-ground support at two study sites. However, the team was able to adjust recruitment methods during the pilot phase.
What was the team’s proactive process in working with the IRB in order to obtain a waiver of consent?
The NOHARM intervention has sustained high-level institutional support despite the impact of COVID-19.
Read more about the NOHARM NIH Collaboratory Trial.
Tags
#pctGR, @Collaboratory1