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The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

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dc.contributor.authorKatz, Joel
dc.contributor.authorWeinrib, Aliza
dc.contributor.authorFashler, Samantha, R.
dc.contributor.authorKatznelson, Rita
dc.contributor.authorShah, Bansi, R.
dc.contributor.authorLadak, Salima
dc.contributor.authorJiang, Jiao
dc.contributor.authorLi, Qing
dc.contributor.authorMcMillon, Kayla
dc.contributor.authorSanta Mina, Daniel
dc.contributor.authorWentlandt, Kirsten
dc.contributor.authorMcRae, Karen
dc.contributor.authorTamir, Diana
dc.contributor.authorLyn, Sheldon
dc.contributor.authorde Perrot, Marc
dc.contributor.authorRao, Vivek
dc.contributor.authorGrant, David
dc.contributor.authorRoche-Nagle, Graham
dc.contributor.authorCleary, Sean, P.
dc.contributor.authorHofer, Stefan
dc.contributor.authorGilbert, Ralph
dc.contributor.authorWijeysundera, Duminda
dc.contributor.authorRitvo, Paul
dc.contributor.authorJanmohamed, Tahir
dc.contributor.authorO'Leary, Gerald
dc.contributor.authorClarke, Hance
dc.date.accessioned2015-10-06T13:00:25Z
dc.date.available2015-10-06T13:00:25Z
dc.date.issued2015-10
dc.description.abstractChronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5–10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients’ pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth.en_US
dc.description.sponsorshipJoel Katz is supported by Canadian Institutes of Health Research Canada Research Chair in Health Psychology at York University. Hance Clarke is supported by a Merit Award from the Department of Anesthesia, University of Toronto and received funding from the Ontario Ministry of Health and Long Term Care, Medically Complex Patients Demonstration Project Program for a project entitled “The Transitional Pain Service Demonstration Project”.
dc.identifier.citationKatz, et al. (2015). The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain. Journal of Pain Research, 8, 695-702.
dc.identifier.issn1178-7090
dc.identifier.urihttp://hdl.handle.net/10315/30372
dc.language.isoenen_US
dc.publisherDove Medical Press Limiteden_US
dc.rightsAttribution-NonCommercial-NoDerivs 2.5 Canada*
dc.rights.articlehttps://www.dovepress.com/articles.php?article_id=24151
dc.rights.journalhttps://www.dovepress.com/journal-of-pain-research-journalen_US
dc.subjectTransitional Pain Service, chronic postsurgical pain, transition to chronic pain, opioid use, multidisciplinary treatmenten_US
dc.titleThe Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain
dc.typeArticleen_US

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