Integrating Nonpharmacological Options Into Perioperative Pain Care: A Cluster Randomized Clinical Trial
Authors' conclusion
In this cluster randomized clinical trial of patients undergoing surgery, an EHR-embedded perioperative pain management intervention promoting nonpharmacologic pain care reduced opioid exposure without changes in patient-reported outcomes
Study context
- Population
- Patients undergoing surgery at 22 surgical practices in 6 surgical centers in Minnesota, Wisconsin, Florida and Arizona
- Participants
- 68,141 surgical procedures
- Comparison
- Electronic health record (EHR)-embedded nonpharmacologic pain care intervention vs usual care
- Interventionn = 43,053
- Usual caren = 25,088reference
- Primary endpoint
- Co-primary: Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Physical Function T scores
- Follow-up
- 1, 2, and 3 months after surgery
Methodological detailscluster randomized, multicentre, Conducted October 16, 2020, through April 30, 2024
- Cluster randomized
- Multicentre
- Conducted October 16, 2020, through April 30, 2024
Primary result
As reported in the abstract
Intervention vs Usual careAdjusted mean difference (95% CI)P value
PROMIS pain interference
0.09(−0.18 to 0.36)
P = 0.51PROMIS physical function
0.15(−0.11 to 0.41)
P = 0.27Secondary outcomes
| Outcome | Estimate | P value | |
|---|---|---|---|
| Total postoperative opioid exposureAdjusted mean difference ≈260 MMEs per patient | rate ratio 0.90 (95% CI 0.82–0.99) | P = 0.03 | |
| Opioid administration during hospitalizationAdjusted mean difference ≈85 MMEs | adjusted rate ratio 0.94 (95% CI 0.90–0.97) | P = 0.001 | |
| 0.512Ratio (log scale) |
Anxiety and health care utilization
- No changes in anxiety or health care utilization
Safety
- No changes in adverse events
Original publication
Integrating Nonpharmacological Options Into Perioperative Pain Care: A Cluster Randomized Clinical Trial. JAMA Netw Open. Published 1 September 2026. doi:10.
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