The Adolescent Surgery Experience: A Mixed Methods Analysis

  • STATUS
    Recruiting
  • End date
    Dec 14, 2023
  • participants needed
    500
  • sponsor
    Children's Hospital of Philadelphia
Updated on 4 October 2022
opioid
elective surgery
anxiety
chronic pain
opioid use

Summary

New chronic pain and opioid use are reported as prevalent among adolescents undergoing major surgery; many unanswered questions remain regarding recovery and the anticipated pain trajectory across procedures and the interaction between pain treatment, acute inflammation and new chronic pain. Broadly, the proposed study will characterize the adolescent's postoperative recovery experience, and establish the anticipated pain trajectory across a range of procedures.

Description

The proposed study will characterize the adolescent's postoperative pain and recovery experience. Using a mixed methods design, Investigators will follow a diverse cohort of up to 500 adolescents undergoing surgery at the Children's Hospital of Philadelphia (CHOP) over six months to systematically characterize their recovery trajectory. The primary objective is to characterize development of new chronic pain in the context of longitudinal pain trajectories among adolescents in the first 6 months after surgery and to quantify implications of post-surgical pain and pain treatment. The secondary objectives are to determine factors associated with prolonged opioid use after surgery compared to peers (measured in days to discontinuation) and to characterize factors associated with delayed recovery from surgery compared to peers. A baseline survey, including an anxiety and depression screen using the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) surveys will be collected after consent and prior to surgery; subsequent post-operative surveys will be collected at one & two weeks, one month, then monthly up to 6 months with total of 8 surveys. The PHQ-9 and GAD-7 will also be administered on month 1, month 3, and month 5. A subgroup of patients will be invited to complete a qualitative interview one month and three months after surgery (+/- 14 days). Adolescents may participate in the 3-month interview if they did not participate in the 1-month interview. The team will select adolescents who report higher pain scores compared to peers undergoing similar procedures on the Weeks 1, 2 and 3 month surveys and a sample of adolescents who are recovering as anticipated. Interviews will take place via telephone or CHOP approved videoconferencing platform with transcription and transcripts, entered in REDCap, that only contain the patient's study identification (ID) as a personal identifier. It is anticipated that some adolescents will decline participation in the one-month survey; they will not be approached to participate in the three-month survey unless they indicate willingness to receive an invitation upon submitting the Month 3 survey. It is also anticipated that individuals may decline to participate in the three-month survey and Investigators will plan to extend additional invitations to complete approximately 25 interviews at each interval.

Details
Condition Pain, Postoperative, Pain, Pain, Acute, Pain, Chronic, Adolescent Behavior, Opioid Use
Treatment baseline survey, qualitative interviews, Post Operative Surveys
Clinical Study IdentifierNCT05482919
SponsorChildren's Hospital of Philadelphia
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Males or females age 11 to 21 years
Scheduled for non-cardiac surgery at one of five CHOP surgical centers
American Society of Anesthesiologists Physical Status (ASA) ≤ 3
Girls 11 years of age and older must have a negative urine/serum pregnancy test
Parental/guardian permission (informed consent) if participant <18 years old and if appropriate, child assent

Exclusion Criteria

Subjects with limited English proficiency
History of chronic pain
History of prior opioid use >5 consecutive days for acute pain or >10 consecutive days for major surgery in their life time
Pregnant or lactating females
Subjects who, in the opinion of the investigator, may be non-compliant with study schedules
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