{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T09:40:06Z","timestamp":1758966006648,"version":"3.44.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1 TR001864"],"award-info":[{"award-number":["TL1 TR001864"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The management of analgesia in people hospitalized with chronic pain and elevated risk for opioid\u2010related harm is challenging. While opioid stewardship programs could provide guidance, their feasibility in this population has not been examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To develop a case identification tool and evaluate the feasibility of an electronic medical record (EMR)\u2010delivered opioid stewardship and pain intervention among hospitalized people with chronic pain and elevated risk for opioid\u2010related harm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After developing and evaluating the operating characteristics of a case identification tool to identify people with chronic pain and elevated risk for opioid\u2010related harm, hospitalized adults with chronic pain and elevated risk for opioid\u2010related harm were randomized to an EMR\u2010delivered opioid stewardship and pain intervention versus usual care. Primary outcomes were feasibility\u2010based. Exploratory outcomes were pain\u2010related clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The case identification tool had a sensitivity of 88.9% and a specificity of 95.7%. The trial recruited 52\/97 (54%) of potential participants who completed 52\/52 (100%) potential assessments and of whom 45\/52 (87%) were retained in the study at 4 weeks, demonstrating feasibility. On average, both treatment arms received 56% of the recommended guideline\u2010concordant care and there was no significant difference in opioid and pain\u2010related care in the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is both feasible to develop an EMR\u2010based tool to prospectively identify hospitalized people with chronic pain and elevated risk for opioid\u2010related harm as well as recruit these individuals to an EMR\u2010delivered opioid stewardship and pain intervention. Additional strategies to support the provision of guideline\u2010concordant care may be warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.70066","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T07:24:20Z","timestamp":1745479460000},"page":"1079-1086","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intervention for hospitalized people with chronic pain and elevated risk for opioid\u2010related harm: A pilot randomized controlled trial"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5624-2434","authenticated-orcid":false,"given":"Melissa B.","family":"Weimer","sequence":"first","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Sections of Health Policy and Management, and Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele J.","family":"Buonora","sequence":"additional","affiliation":[{"name":"National Clinician Scholars Program, Yale School of Medicine New Haven Connecticut USA"},{"name":"Division of General Internal Medicine Montefiore Medical Center Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra M.","family":"Hajduk","sequence":"additional","affiliation":[{"name":"Section of Geriatrics Department of Medicine, Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam L.","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Yale New Haven Hospital New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna R.","family":"Daggula","sequence":"additional","affiliation":[{"name":"Joint Data Analytics Team Yale New Haven Health System New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Becker","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Pain Research, Informatics, Multimorbidities &amp; Education Center Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA"},{"name":"General Internal Medicine Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarwat I.","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"National Clinician Scholars Program, Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Fiellin","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Sections of Health Policy and Management, and Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229174"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1424"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2002.10625.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-200105000-00007"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000255"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3571-4"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2014.08.004"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-2-200601170-00010"},{"key":"e_1_2_8_10_1","unstructured":"The Joint Commission Standards Pain Assessment and Management Understanding the Requirements. 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