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Behavioral Intervention

Better Options for Chronic Cancer Pain

N/A

Waitlist Available

Led By Maria J. Silveira, MD MA MPH

Research Sponsored by VA Office of Research and Development

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Be older than 18 years old

Must not have

Veterans with total daily opioid doses >= 300 Morphine Milligram Equivalents (MME) will be excluded (higher doses require tapering prior to rotation to buprenorphine, which is something the investigators do not want to examine in this study)

Timeline

Screening 3 weeks

Treatment Varies

Follow Up 9 months

Awards & highlights

No Placebo-Only Group

Summary

This trial aims to help cancer survivors who are still using opioids long after their cancer treatment. These survivors are at risk of opioid addiction and overdose. The study will look at four different ways to reduce opioid

Who is the study for?

This trial is for cancer survivors who have finished treatment but are still using opioids, potentially facing addiction or overdose risks. It's designed to help them find non-opioid pain relief alternatives.

What is being tested?

The study tests four strategies: multimodal pain care, reducing opioid doses gradually (tapering), switching from other opioids to buprenorphine (rotation), and optimizing medications to manage chronic cancer-related pain.

What are the potential side effects?

Possible side effects may include withdrawal symptoms due to opioid tapering, reactions to medication changes like buprenorphine rotation, and general discomfort that can come with adjusting pain management treatments.

Eligibility Criteria

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

Select...

I take less than 300mg of opioids daily.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ 9 months

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~9 months

This trial's timeline: 3 weeks for screening, Varies for treatment, and 9 months for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Opioid dose reduction + Pain response (binary: yes/no)

Secondary study objectives

Opioid dose

Pain intensity

Pain interference

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

6Treatment groups

Experimental Treatment

Group I: Multimodal pain care 9 monthsExperimental Treatment1 Intervention

Findings from the comprehensive pain assessment will be used to inform an individualized, multimodal plan crafted by the team physician with the subject's collaboration

Group II: Multimodal pain care 6 months / Opioid tapering 3 monthsExperimental Treatment2 Interventions

Findings from the comprehensive pain assessment will be used to inform an individualized, multimodal plan crafted by the team physician with the subject's collaboration. After 6 mo, subjects will attempt to taper opioids

Group III: Medication optimization 9 monthsExperimental Treatment1 Intervention

Findings from the comprehensive pain assessment will be used to inform a medication-focused pain plan. Medications will be optimized following an algorithm the investigators created based upon NCCN's Survivorship Guidelines and AHRQ's comprehensive review of non-opioid treatments for chronic pain.

Group IV: Medication optimization 6 months/ Buprenorphine rotation 3 monthsExperimental Treatment2 Interventions

Group V: Medication optimization 6 mo/ Opioid tapering 3 monthsExperimental Treatment2 Interventions

Group VI: Medication optimizationExperimental Treatment2 Interventions

Findings from the comprehensive pain assessment will be used to inform a medication-focused pain plan.

0 / 1Eligibility criteria met