Life Care Specialists (LCS) with a Focus on Multi-modal Non-Pharmacologic Strategies for Pain Control in the Aftermath of Orthopaedic Trauma
Principal Investigator:
Mara Schenker, MD | Grady Memorial Hospital, Orthopedic Center
Co-Investigators:
Alaina Steck, MD | Grady Memorial Hospital, Emergency Department
Briony Swire-Thompson, PhD |Northeastern University
Cammie Wolf Rice | Christopher Wolf Crusade
Elaine Miller-Karas, MSW, LCSW | Trauma Resource Institute
Why is this project important?
Post-trauma pain management is centered on opioid pharmaceutical analgesia with little emphasis on individualized risk assessment for opioid use disorders, nonpharmacologic strategies for pain control, and early intervention by mental health/substance use specialists. To address this gap, researchers introduced a Life Care Specialist (LCS) as an integral member of the orthopaedic trauma clinical team, with a focus on “pain coaching” for trauma patients.
Key Contribution to Science:
Results of this study will identify which components of the LCS intervention contribute to effectiveness, and whether LCS affects long-term misuse risk and overdose-related deaths. This study aims to validate the role of life care specialists for expansion to other sites as clinical standard of care.
Pain management following trauma continues to be centered around opioid pharmaceutical analgesia with little emphasis on individualized risk assessment for opioid use disorders, nonpharmacologic strategies for pain control, and early intervention by mental health/substance use specialists. To address this gap, the research team introduced a Life Care Specialist (LCS) as an integral member of the orthopaedic trauma clinical team, with a focus on “pain coaching” for trauma patients. The LCS is based on the Certified Child Life Specialists (CCLS) model, which when employed post surgically, has been shown to lead to increased patient cooperation, reductions in perceived pain, and higher patient satisfaction scores, and fewer opioid prescriptions. In a small pilot study, the research team demonstrated feasibility and operationalization of the LCS approach in a hospital setting and generated preliminary that demonstrate that the LCS approach increases patient satisfaction and may decrease opioid use. The goal of this study group is to determine which components of the LCS intervention contribute to effectiveness, whether LCS affects long-term abuse risk and overdose-related deaths, and ultimately, to nationally scale this for all patients receiving an opioid prescription.
- Evaluate the effectiveness of LCS intervention on trauma patients' perception of pain and opioid utilization in the immediate aftermath of trauma.
- Evaluate the effectiveness of Life Care Specialist interventions on reducing long-term postoperative opioid medication utilization.
- Explore the feasibility of utilizing actigraphy devices to capture postoperative functional outcomes among patients during their hospitalization and up to 2-weeks postoperatively following orthopaedic trauma.
2. Integration of Life Care Specialists into Orthopaedic Trauma Care to Improve Postoperative Outcomes: A Pilot Study. Pain Management Nursing.
3. A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute orthopaedic care settings.Journal of Orthopaedic Trauma International.
4. Defense and Veterans Pain Rating Scale scores associated with longer PROMIS measures.Regional Anesthesia & Pain Medicine.
Publication Brief