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Opioid UsePAC-planNCT06055205

A Pain and Coordination Plan for Reduced Opioid Use After Accidental Injuries

A study testing PAC-plan in people with Opioid Use and Injury Traumatic, run by University of Oslo at 1 site in Norway.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This clinical trial aims to lower the number of people who use opioids and improve the quality of health in patients who have experienced accidental injury by implementing a Pain and Coordination Plan (PAC-plan). The PAC-plan will be given upon discharge from the hospital. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Opioid Use, Injury Traumatic, Pain, Postoperative
What is being tested?
PAC-plan
Could I receive a placebo?
No, everyone receives an active treatment
How many people
271 participants
Where
1 siteNorway
Study dates
25 Sep 2023to Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults ≥18 years of age who have undergone acute orthopaedic surgery following accidental injury
  • Discharged on opioid medication

Who cannot join

  • Unable to read, speak, and write Norwegian
  • Severe cognitive impairment/inability to consent
  • Not discharged to home
  • Currently in cancer treatment

Trial locations and contacts

1 site in 1 country.

Norway1 site
  • Oslo University Hospital

    Oslo, 0424

Other trials in Norway

About this study

Official title: A Pain and Coordination Plan (PAC-plan) in Transition Between Hospital and Primary Care to Reduce Opioid Use in Patients After Accidental Injuries: A Randomized Controlled Trial

This clinical trial aims to lower the number of people who use opioids and improve the quality of health in patients who have experienced accidental injury by implementing a Pain and Coordination Plan (PAC-plan). The PAC-plan will be given upon discharge from the hospital.

The main questions this study aims to answer are:

Read more
  • Can the PAC-plan reduce opioid use in patients after accidental injuries?
  • Can the PAC-plan increase quality of life in patients after accidental injuries?
  • Is implementation of the PAC-plan after accidental injuries cost-effective?

Participants will be randomly assigned to the PAC-plan or usual care. The PAC-plan includes:

  • an opioid management plan upon discharge from the hospital
  • an appointment with his/her general practitioner within 2-4 weeks after discharge
  • the general practitioner will be given the opportunity for increased collaboration with the hospital specialists

Participants in both groups will be asked to answer questionnaires about their health at discharge, and at 6 and 52 weeks after discharge from the hospital. In addition, the researchers will use data from the Norwegian Prescription Database to measure use of opioids and other relevant drugs, the Norwegian Patient Registry (NPR) and the Norwegian Registry for Primary Health Care (KPR) for the use of health care services and Statistics Norway for data on sick leave and other social security benefits.

Read the detailed description

Introduction: Patients experiencing serious injuries are at risk of developing long-term opioid use, yet many don't receive plans for opioid reduction when discharged from the hospital. General Practitioners (GPs) also experience insufficient communication from the hospital on pain management plans. Opioids are often essential for managing acute pain in patients following serious injuries. However, it is crucial to prioritize safe and appropriate pain management in subsequent phases. The opioid epidemic in the USA, characterized by opioid use disorders and addiction, has resulted in high mortality rates and a public health crisis. In 2017, opioid dependence outside the USA was estimated to account for over 1% of age-standardized years lived with disability in 135 countries. Considering the devastating impact of the opioid epidemic in the USA, it is imperative to draw lessons from these experiences and implement preventive measures to avoid a similar crisis in other countries.

Aim: This study aims to explore if a Pain and Coordination Plan (PAC-plan) for patients after accidental injury can reduce opioid use and improve quality of life, and if the intervention is cost-effective.

Methods: The study is designed as a prospective randomized controlled trial (RCT) to evaluate the effect of a PAC-plan. The PAC-plan consists of three main elements: an opioid management plan upon discharge from the hospital, an appointment with the participant's regular GP within 2-4 weeks after discharge and an opportunity for increased collaboration between GP and hospital specialists.

Patients will be recruited from the Division of orthopaedic surgery, Oslo University Hospital (OUH), Norway. OUH is a highly specialized hospital in charge of extensive regional and local hospital assignments in the South-Eastern Health region in Norway and is described as a level 1 trauma centre. The primary outcome is oral morphine equivalent (OMEQ) consumption 6 weeks after discharge. Secondary outcome measures are OMEQ 52 weeks after discharge. In addition, registry-based OMEQ and other addictive drugs, pain, health-related quality of life (HRQoL) and other Patient-reported outcome measures (PROMs) at 6 and 52 weeks, and finally use of health care services and sick leave. The registry-based OMEQ will be collected from the Norwegian Prescription Database (NorPD). Data will also be collected from the the Norwegian Patient Registry (NPR), the Norwegian Patient Registry (NPR), the Norwegian Registry for Primary Health Care (KPR) and Statistics Norway.

Being tested
PAC-plan
Keywords
Opioids, Injuries, Pain, Pain management, Collaboration
Medical subject headings
Wounds and Injuries, Pain, Postoperative, Pain, Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PAC-planOther

    The participants will be asked to complete electronic questionnaires at baseline, and at 6 weeks and 52 weeks after discharge from the hospital. The completion of these questionnaires will take place during the 6-week follow-up appointment at the hospital (a standard follow-up for all patients undergoing surgery at the Division of Orthopedic Surgery, Oslo University Hospital, Norway). Additionally, participants will be invited for a phone-based follow-up appointment with the study coordinator 52 weeks after discharge. The participants will receive the questionnaires electronically via SMS or email. If electronic options are not feasible, data can be collected through paper questionnaires sent by mail. Data will not be directly obtained from general practitioners.

Study groups in NCT06055205
Study groupRoleWhat they receive
PAC-planExperimentalThe patients receive a Pain- and Coordination plan (PAC-plan) at discharge from the hospital. The PAC-plan includes: * Upon discharge, patients have a patient-centered conversation and receive written information covering patient education on opioids, a tapering plan, and a plan for contact and follow-up with the general practitioner. The information is based on the Norwegian National Guide for Addictive Medications. * Before discharge, patients are scheduled an appointment with the GP, preferably within the first 2 weeks (2-4 weeks), for a follow-up regarding the injury and pain management. * The GP is invited to maintain contact with the study nurse at the hospital for one year. The general practitioner can call for consultation with the study nurse, and if necessary, be connected with relevant medical specialists for advice and eventually further follow-up.
Receives: Other: PAC-plan
ControlNo interventionTreatment and follow-up as usual.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Opioid use

    Opioid use last 24 hours measured in oral morphine equivalents (OMEQ), self-reported

    Measured: 6 weeks post-discharge

Secondary outcomes (20)
  1. Opioid use

    Opioid use last 24 hours measured in oral morphine equivalents (OMEQ), self-reported

    Measured: 52 weeks post-discharge

  2. Opioid use measured in oral morphine equivalents (OMEQ), registry-based

    The Norwegian Prescription Database, NorPD

    Measured: 6 weeks post-discharge

  3. Opioid use measured in oral morphine equivalents (OMEQ), registry-based

    The Norwegian Prescription Database, NorPD

    Measured: 52 weeks post-discharge

  4. Numeric Rating Scale for pain intensity scores

    Pain intensity, self-reported by Numeric Rating Scale (NRS-11). Scale from 0 to 10, with 0 being "no pain" and 10 being "the worst pain imaginable."

    Measured: 6 weeks post-discharge

  5. Numeric Rating Scale for pain intensity scores

    Pain intensity, self-reported by Numeric Rating Scale (NRS-11). Scale from 0 to 10, with 0 being "no pain" and 10 being "the worst pain imaginable."

    Measured: 52 weeks post-discharge

  6. EQ-5D-5L (EuroQol, 5 dimensions, 5 levels) for health-related quality of life

    Health-related quality of life measured with the EQ-5D-5L. The EQ-5D-5L consists of two parts: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The EQ visual analogue scale (EQ VAS) records the patient's self-rated health on a VAS ranging from 0 to 100, with higher scores indicating better self-reported health.

    Measured: 6 weeks post-discharge

  7. EQ-5D-5L (EuroQol, 5 dimensions, 5 levels) for health-related quality of life

    Health-related quality of life measured with the EQ-5D-5L. The EQ-5D-5L consists of two parts: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The EQ visual analogue scale (EQ VAS) records the patient's self-rated health on a VAS ranging from 0 to 100, with higher scores indicating better self-reported health.

    Measured: 52 weeks post-discharge

  8. Norwegian Injustice Experience Questionnaire (IEQ-N)

    Perceived injustice measured with the Injustice Experience Questionnaire (IEQ). The IEQ is a self-report 12-item questionnaire and each item is scored on a five-point scale from zero ("never") to four ("all the time"). The total score on the IEQ ranges from 0 to 48, with higher scores indicating higher levels of perceived injustice

    Measured: 6 weeks post-discharge

  9. Norwegian Injustice Experience Questionnaire (IEQ-N)

    Perceived injustice measured with the Injustice Experience Questionnaire (IEQ). The IEQ is a self-report 12-item questionnaire and each item is scored on a five-point scale from zero ("never") to four ("all the time"). The total score on the IEQ ranges from 0 to 48, with higher scores indicating higher levels of perceived injustice

    Measured: 52 weeks post-discharge

  10. Life Orientation Test Revised (LOT-R)

    Optimism measured with the Life Orientation Test Revised (LOT-R). The measure consists of 10 items, and participants indicate their level of agreement with each item on a 5-point scale ranging from 0 (strongly disagree) to 4 (strongly agree). The scores on this scale can range from 0 to 24, with higher scores indicating greater levels of optimism and lower scores indicating lower levels of optimism.

    Measured: 6 weeks post-discharge

  11. Life Orientation Test Revised (LOT-R)

    Optimism measured with the Life Orientation Test Revised (LOT-R). The measure consists of 10 items, and participants indicate their level of agreement with each item on a 5-point scale ranging from 0 (strongly disagree) to 4 (strongly agree). The scores on this scale can range from 0 to 24, with higher scores indicating greater levels of optimism and lower scores indicating lower levels of optimism.

    Measured: 52 weeks post-discharge

  12. Patient Health Questionnaire-9

    Depression symptoms and severity measured by the Patient Health Questionnaire-9 (PHQ-9).The PHQ-9 consists of nine items and the participants rate the frequency of each symptom on a Likert scale ranging from 0 (not at all) to 3 (nearly every day). The scores can range from 0-27. In addition to a total score, categories are defined to indicate severity of depression symptoms. These categories are defined as follows: none (total score from 0 to 4), mild (total score from 5 to 9), moderate (total score from 10 to 14), moderately severe (total score from 15 to 19), and severe (total score from 20 to 27).

    Measured: 6 weeks post-discharge

  13. Patient Health Questionnaire-9

    Depression symptoms and severity measured by the Patient Health Questionnaire-9 (PHQ-9).The PHQ-9 consists of nine items and the participants rate the frequency of each symptom on a Likert scale ranging from 0 (not at all) to 3 (nearly every day). The scores can range from 0-27. In addition to a total score, categories are defined to indicate severity of depression symptoms. These categories are defined as follows: none (total score from 0 to 4), mild (total score from 5 to 9), moderate (total score from 10 to 14), moderately severe (total score from 15 to 19), and severe (total score from 20 to 27).

    Measured: 52 weeks post-discharge

  14. HUNT (the Nord-Trøndelag health study) physical activity questionnaire (HUNT 1 PA-Q)

    The HUNT 1 PA-Q consists of three sets of questions addressing the average number of times exercising each week, the average intensity and average hours each time. Each set of questions has five, three, or four response choices, respectively. The HUNT 1 PA-Q measures physical exercise as the product of average frequency (0.0-5.0 points), duration (0.10-1.00 points) and intensity (1-3 points) each week, giving an index ranging from 0.00 to 15.00, with 15.00 as the best score

    Measured: 6 weeks post-discharge

  15. HUNT (the Nord-Trøndelag health study) physical activity questionnaire (HUNT1 PA-Q)

    The HUNT 1 PA-Q consists of three sets of questions addressing the average number of times exercising each week, the average intensity and average hours each time. Each set of questions has five, three, or four response choices, respectively. The HUNT 1 PA-Q measures physical exercise as the product of average frequency (0.0-5.0 points), duration (0.10-1.00 points) and intensity (1-3 points) each week, giving an index ranging from 0.00 to 15.00, with 15.00 as the best score.

    Measured: 52 weeks post-discharge

  16. Insomnia Severity Index (ISI) last 2 weeks

    Perceived insomnia severity measured by the Insomnia Severity Index (ISI). The ISI consists of seven items and the participants rate each item on a scale from 0 to 4, from less to more severe. The total score is the sum of each individual item and can range from 0 to 28 (28 = most severe insomnia).

    Measured: 6 weeks post-discharge

  17. Insomnia Severity Index (ISI) last 2 weeks

    Perceived insomnia severity measured by the Insomnia Severity Index (ISI). The ISI consists of seven items and the participants rate each item on a scale from 0 to 4, from less to more severe. The total score is the sum of each individual item and can range from 0 to 28 (28 = most severe insomnia).

    Measured: 52 weeks post-discharge

  18. Cost-effectiveness

    The cost-effectiveness of the intervention will be assessed by the incremental cost-effectiveness ratio (ICER), defined by the incremental costs (the difference in costs between the intervention group and the control group) per quality-adjusted life year (QALY) gained. In the health economic analysis, we will also present differences in costs associated with healthcare service consumption (based on data from the Norwegian Prescription Database (NorPD), the Norwegian Patient Registry (NPR), and the Norwegian Registry for Primary Health Care (KPR), as well as differences in sick leave and disability benefits (using data from Statistics Norway).

    Measured: 52 weeks post-discharge

  19. Use of addictive and psychoactive drugs, registry-based

    Prescribed addictive medication (other than opioids) and psychoactive drugs (antidepressants and antipsychotics). Obtained from the Norwegian Prescription Database, NorPD.

    Measured: 6 weeks post-discharge

  20. Use of addictive and psychoactive drugs, registry-based

    Prescribed addictive medication (other than opioids) and psychoactive drugs (antidepressants and antipsychotics). Obtained from the Norwegian Prescription Database, NorPD.

    Measured: 52 weeks post-discharge

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Sep 2023
  2. Study start25 Sep 2023
  3. Primary completion30 Apr 2026
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
The study will use a prospective randomized controlled trial design. Participants will be assigned randomly to study conditions (1:1) through permuted block randomization with various sizes of the blocks (4, 6, 8, 10) in random order. The randomization will be performed manually by the principle investigator (PI). Sealed, opaque, numbered envelopes will be used, and will be opened after consent from the patient. For the intervention group, the study coordinator will contact the patient's general practitioner (GP) by calling the doctor's office to obtain consent for participation. For the control group, the GP will not be asked for consent. To ensure that no GPs are included in both groups, the GPs retain their initial allocation if they have additional patients in the project. In practice, this corresponds to cluster-randomization at the GP level (and will be treated as such in the statistical analyzes).
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
271 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06055205
Sponsor's protocol ID
487948 (REK)
Acronym
PAC-plan
Status last verified
May 2026
First submitted
19 Sep 2023
Last updated
8 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: It is not yet known if there will be a plan to make individual patient data (IPD) available.

Questions about this trial

What is this clinical trial studying?

A study testing PAC-plan in people with Opioid Use and Injury Traumatic, run by University of Oslo at 1 site in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 8 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Opioid use (time frame: 6 weeks post-discharge). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2026.

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