# Reducing Chronic Opioid Use Among Veterans Undergoing Community Care Surgery Using a Transitional Pain Service

> **NIH VA I01** · VA SALT LAKE CITY HEALTHCARE SYSTEM · 2024 · —

## Abstract

Background: The VA Community Care program has improved access to surgical care for Veterans unable to
have treatment at VA Medical Centers in a timely fashion. However, the delivery of surgical care outside the
VA poses barriers to care coordination for pain management during the transitions before and after surgery,
leading to increased risk for chronic opioid use (COU). A multidisciplinary approach to perioperative pain
management known as the Transitional Pain Service (TPS) has been shown to effectively reduce COU among
Veterans after orthopedic surgery, but it is unknown whether this approach can be delivered virtually to reduce
COU among at-risk Veterans undergoing similar procedures at non-VA hospitals.
Significance: Community Care referrals for orthopedic surgery are very common (>30,000 cases annually)
and place Veterans at risk for COU. The proposed study represents a unique opportunity to evaluate a
telehealth TPS approach to address care coordination and reduce risks for COU among Veterans when they
transition between VA and non-VA surgical care.
Innovation & Impact: No prior studies have evaluated the impact of a TPS approach to improve coordination
of pain management for Veterans undergoing major surgery at non-VA hospitals. This project presents a
unique opportunity to apply an evidence-based approach to help improve the coordination of pain management
for Veterans using Community Care for orthopedic surgery at non-VA hospitals and reduce the risk of opioid
misuse. Data from this study will be critical to support the broader dissemination of telehealth TPS across the
national VHA.
Specific Aims:
Aim 1. To evaluate a telehealth transitional pain service approach for preventing COU among Veterans
referred to non-VA hospitals for orthopedic surgery.
Aim 2. To identify barriers and facilitators of care coordination when Veterans undergo orthopedic surgery at
non-VA hospitals and use telehealth TPS.
Aim 3. To compare patient and payer costs with clinical outcomes among Veterans receiving telehealth
transitional pain service versus standard in-person follow-up visits for pain management.
Methodology: In Aim 1, we will randomize Veterans referred to non-VA hospitals in VISN-19 for orthopedic
joint procedures at two VAMCs to a TPS with regular follow-up telehealth visits after surgery versus only
receiving standard care for managing opioid tapering in the 90-days following hospital discharge. In Aim 2, we
will conduct interviews with VA providers and Veterans who used Community Care for orthopedic surgery to
identify factors that influence coordination of pain management. And in Aim 3, we will estimate patient and VA
perspective costs when Veterans use Community Care and perform a cost-effectiveness analysis comparing
telehealth TPS to receiving only standard follow-up care with surgical and PCP teams for pain management.
Next Steps/Implementation: The research findings from this study will be used to evaluate and refine the
telehealth TPS ...

## Key facts

- **NIH application ID:** 10749815
- **Project number:** 1I01HX003599-01A1
- **Recipient organization:** VA SALT LAKE CITY HEALTHCARE SYSTEM
- **Principal Investigator:** MICHAEL BUYS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-02-01 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10749815

## Citation

> US National Institutes of Health, RePORTER application 10749815, Reducing Chronic Opioid Use Among Veterans Undergoing Community Care Surgery Using a Transitional Pain Service (1I01HX003599-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10749815. Licensed CC0.

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