Reducing Opioid Use for Pain Management
Data collection and use to prevent opioid dependence.
Project Overview
Updated August 29, 2024
The Problem
Opioids are recognized as an effective tool for managing pain.
However, they can also be addictive, resulting in widespread abuse in recent years and culminating in national health crises in Canada and the U.S.
In addition, some patients don’t respond well to opioids after surgery. Adverse symptoms include lethargy, slow and laboured breathing, as well as delirium. In some cases, pain can worsen when patients are prescribed higher dosages.
At least 6 per cent of surgery patients who are prescribed opioids become persistent opioid users. Unfortunately, physicians do not have the information they need to minimize this risk at the time of prescribing medication, nor do they receive follow-up data to reduce the rates of addiction.
How We Are Solving It
In response, Careteam Technologies is leading a project called Reducing Opioid Use for Pain Management. The diverse project team includes Xerus Medical, Thrive Health, Excelar Technologies, BC Children’s Hospital Research Institute, British Columbia’s Ministry of Health (advisory capacity), Providence Health Care, the National Research Council of Canada, Health Canada, the University of British Columbia and the Canadian Medical Association’s innovation-focused subsidiary Joule.
The consortium is building a post-surgery monitoring system that will collect patient data and provide doctors with the information they need to better manage the prescription and use of opioids.
Patient data from multiple sources, such as prescription data and patient surveys, will be collected and centralized to create a complete snapshot of a patient’s treatment before and after surgery. Taken together, this can be used by the patient and doctor together to improve pain management and implement strategies that reduce opioid use.
The team is starting with the creation of a Perioperative Monitoring System to help tackle the opioids crisis. The data platform could also be used to enhance the electronic health records (EHR) systems that presently capture billing, medical and legal documentation of a patient’s clinical visits and hospital workflows. Over time, additional patient information, including genomics and pharmacogenetics data could be incorporated.
Patient data collected from the system could be combined with the EHRs in a way that enables doctors and patients to make important decisions. With further development, the POMS technology and platform can also be adapted for pain management strategies involving chronic conditions such as arthritis.
The Result
This project successfully demonstrated technical feasibility and potential benefits of combining the ability to filter patients based on profiles and medical history with integration to patient surgery dates. This enabled automated onboarding of a selective high-risk cohort of patients to support provider monitoring throughout their surgery and during at-home recovery using tailored sets of post-surgical check-ins. High-risk patients are streamed to the Careteam technology platform, where they receive more pain-related interventions to help improve their outcomes post-surgery. Low risk patients stay in the Thrive Health platform, where their quality of life was monitored for one year after surgery. The Thrive Health platform also collects data on pain levels, medication use and readmission rates.
This project led to the creation of the Transitional Pain Clinic at St. Paul’s Hospital. Once the technology was in place to identify high-risk patients, the clinical team realized they needed to put additional supports in place to help these patients. In operation since 2021, the clinic is staffed by two physicians, one nurse navigator and a psychologist. The team sees patients before surgery and educates them on how to manage the risks of opioid dependency. After the surgery, the team continues to see the patients to help them manage persistent pain. Almost all patients are weaned from opioids during their time with the clinic.
The solution has ongoing potential scalability across several high-risk conditions e.g. postpartum depression, frail and elderly.
