# Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial

> **NIH NIH UH3** · MAYO CLINIC ROCHESTER · 2020 · $1,521,299

## Abstract

ABSTRACT
Prescriptions for narcotic pain relief after surgery result in unintended prolonged opioid use for
hundreds of thousands of Americans. That trend fuels an excess supply of opioids that can
lead to dependence, addiction, diversion, and overdoses on a national scale. Non-
pharmacological pain care is effective and recommended by guidelines for perioperative pain
while offering a more favorable risk benefit ratio. However, nonpharmacological pain care is
rarely used as first or second-line therapy after surgery. Patient and clinician decision support
interventions are effective in encouraging patient centered and guideline-concordant care, but
these strategies have not been tested pragmatically as a bundle in every day postoperative pain
care. The NOHARM trial will first confirmed the feasibility of patient-facing as well as clinician-
facing decision support components of an EHR-imbedded evidence-based bundle (Aim 1).
Then we will test our bundle in a step-wedge, cluster randomized trial at 18 sites in 4 Health
Systems (Aim 2) affiliated with one national healthcare organization that uses a common EHR
platform. We will test a sustainable system strategy that could change the paradigm of
perioperative pain management toward nonpharmacological options in a manner that preserves
patient function, honors patient values and maintains availability of opioids as a last resort. This
could serve as a model for healthcare organizations nationally and could be disseminated
through our institution’s ongoing partnership with the largest national EHR vendor. To ensure
our approach is sustainable, we will also study what worked and what did not at all study sites
(Aim 3), focusing on high-risk patients within a parent organization that has expressed a high-
level commitment to addressing the opioid crisis.

## Key facts

- **NIH application ID:** 10210513
- **Project number:** 4UH3AG067593-02
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Andrea Lynne Cheville
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,521,299
- **Award type:** 4N
- **Project period:** 2019-09-30 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10210513

## Citation

> US National Institutes of Health, RePORTER application 10210513, Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial (4UH3AG067593-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10210513. Licensed CC0.

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