The Impact of Nonpharmacological Interventions on Patient Experience, Opioid Use, and Health Care Utilization in Adult Cardiac Surgery Patients: Protocol for a Mixed Methods Study (Preprint)

• DOI: 10.2196/preprints.21350
• Publication Date: 2020-06-15T18:15:43Z
• Authors: Alexander A Brescia; Julie R Piazza; Jessica N Jenkins; Lindsay K Heering; Alexander J Ivacko; James C Piazza; Molly C Dwyer-White; Stefanie L Peters; Jesus Cepero; Bailey H Brown; Faraz N Longi; Katelyn P Monaghan; Frederick W Bauer; Varun G Kathawate; Sara M Jafri; Melissa C Webster; Amanda M Kasperek; Nickole L Garvey; Claudia Schwenzer; Xiaoting Wu; Kiran H Lagisetty; Nicholas H Osborne; Jennifer F Waljee; Michelle Riba; Donald S Likosky; Mary E Byrnes; G Michael Deeb
• Keywords: Outpatient surgery

<sec> <title>BACKGROUND</title> Despite pharmacological treatments, patients undergoing cardiac surgery experience severe anxiety and pain, which adversely affect outcomes. Previous work examining pediatric nonsurgical adult has documented the effectiveness of inexpensive, nonpharmacological techniques to reduce pain as well health care costs length hospitalization. However, impact interventions administered by a dedicated &lt;i&gt;comfort coach&lt;/i&gt; not been evaluated in an surgical setting. </sec> <title>OBJECTIVE</title> This trial aims assess whether trained patient experience, opioid use, utilization compared with usual patients. study 3 specific aims: effect on measure differences inpatient outpatient use postoperative utilization, qualitatively evaluate intervention. <title>METHODS</title> To address these aims, we will perform prospective, randomized controlled 154 at Michigan Medicine. Opioid-naive first-time, elective via sternotomy be undergo targeted from (intervention) versus (control). The individualized 6 points: preoperative clinic, unit day surgery, extubation, chest tube removal, hospital discharge, 30-day clinic follow-up. aim 1, examine perioperative anxiety, self-reported functional status, satisfaction through validated surveys follow-up, 90-day For 2, record collect postdischarge pain-related outcomes 11-item questionnaire Hospital stay, readmission, number days extended facility, emergency room, urgent care, unplanned doctor’s office visit recorded primary composite endpoint defined total spent home within first 30 after surgery. 3, semistructured interviews intervention arm understand thematic analysis. <title>RESULTS</title> trial, funded Blue Cross Shield Foundation 2019, is presently enrolling anticipated manuscript submissions our for end 2020. <title>CONCLUSIONS</title> Data generated this mixed methods highlight effective support multidisciplinary approach during experience. study’s findings may serve foundation subsequent multicenter broader dissemination other types <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT04051021; https://clinicaltrials.gov/ct2/show/NCT04051021 <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/21350