Optimizing Psychosocial Pain Management: Examining Treatment Moderators, Intervention Utilization, and Postoperative Outcomes

 

Project Description:

This project’s primary aim is to identify which surgical patients respond best to one of three preoperative psychosocial interventions, so as to more skillfully personalize pain management strategies.

 

Abstract:

Despite the ongoing opioid epidemic in the United States, opioids remain the primary, post-surgical pain management strategy. In fact, 96% of orthopedic surgery patients fill at least one opioid prescription after surgery, which is how many individuals first become exposed to opioids. Unfortunately, for more than 1 in 16 of these patients— approximately 2 million a year—what began as pain management transitions to addiction.

Alternative pain management strategies are needed to address this problem. This grant hypothesizes that teaching patients alternative mind-body pain management strategies before their surgeries—specifically, mindfulness meditation and hypnotic suggestion—will decrease the percentage of patients who begin misusing opioids after surgery.

To test this hypothesis, the researcher will conduct a randomized controlled trial in a large sample of preoperative orthopedic surgery patients to identify which intervention works best for whom, which intervention patients are most likely to continue using after initial training, and determine whether continued use of these pain management strategies after surgery facilitates postoperative health and recovery. As part of this, the researcher will explore possible treatment moderators using a combination of self-report scales (e.g., personality, psychosocial history), computer-based cognitive tasks (e.g., attention network tasks), and psychophysiological indices (e.g., heart rate variability).

 

Publications:

 

Outcomes:

Data from this seed grant was used to secure a $4,996,715 grant, SMART Embedded Intervention for Military Postsurgical Engagement Readiness (SEMPER),from the Department of Defense’s Congressionally Directed Medical Research Program (W81XWH-21-1-0328).

Data from this seed grant was used to publish the above listed manuscript/publication and mechanistic data from this seed grant is reported in a second manuscript, “No self, no pain: Self-transcendence predicts better pre- and postoperative outcomes in two randomized clinical trials of brief mindfulness-based interventions.” The second manuscript is complete, available in preprint, and will be submitted to the journal Mindfulness (Impact Factor = 4.684) by December 2021. 

Data from this seed grant has been presented at the following professional conferences:

• Integrative Medicine and Health Symposium: one of the 4 most popular presentations, out of 80+ (April 2021)
• Western Psychological Association (April 2021)
• British Psychological Association’s Division of Health and Psychology Annual Conference (June 2021)
• American Psychological Association (August 2021)

 

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