Skip to main content
OpenTrials
Completed

NCT Number: NCT06455345

Online Psychology Program for Chronic Pain After Surgery

This project will evaluate the feasibility of a new fully self-guided online Acceptance and Commitment Therapy (ACT) program entitled Advancing Online Psychology Tools for the Transitional Pain Service (ADOPT-TPS), developed on an online health application platform called Manage My Pain (MMP). The ACT program is designed to teach mindfulness skills and provide psychoeducation about post-surgical pain. The feasibility of the self-guided online program will be compared to a pre-existing psychologist-guided workshop that delivers the same program. It is anticipated that the self-guided online ACT program will be deemed feasible by participants.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Post-surgical Pain Acute Pain Chronic Pain Neurologic Manifestations Pain Pain, Acute Pain, Chronic Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Post-Surgical Pain, Chronic Postoperative Complications Signs and Symptoms

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Toronto General Hospital- The Department of Anesthesia and Pain Management, Toronto, Ontario, Canada

Loading trial locations.

About this study

The Transitional Pain Service (TPS) at Toronto General Hospital is a multidisciplinary treatment program that aims to prevent chronic post-surgical pain (CPSP) and persistent opioid use after surgery. CPSP is a major public health concern impacting from 10% up to 70% of patients, depending on the type of surgery. Those experiencing CPSP are at higher risk for prolonged opioid use, which introduces challenges like addiction, misuse, and overdose. Acceptance and Commitment Therapy (ACT) is an evidence-based psychology intervention that is effective in reducing patients' risk of CPSP and opioid use. However, access to this intervention is currently limited to predominantly in-person, specialized hospital-based clinic settings like the TPS, which prioritize patients at highest risk for CPSP and often require physician referrals for quick access. There is a need for such treatment approaches to spread to other institutions and to be available for lower-risk post-surgery patients, yet the shortage of specialized pain psychologists creates a barrier to widespread dissemination. The current project will evaluate the feasibility of a novel fully self-guided online ACT intervention entitled Advancing Online Psychology Tools for the Transitional Pain Service (ADOPT-TPS), developed on a mobile health application platform called Manage My Pain (MMP). A randomized, controlled pilot feasibility trial will evaluate the efficacy of ADOPT-TPS by comparing it to a pre-existing psychologist-guided workshop. Once tested, this scalable, evidence-based online intervention can be easily implemented at institutions across Canada and beyond to address CPSP and opioid use without the need for specialized pain psychologists on staff.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who received a post-surgical referral to the TPS
  • Patients who have access to a device that can connect to the Internet

Exclusion criteria

  • Patients who have received TPS psychology treatment
  • Patients with a known history of serious mental illness (e.g., psychosis and/or active mania)
  • Patients who have limited comprehension of English or comprehension deficits due to dementia

Treatment and study plan

Self-Guided Online ACT Program

Device

Participants will be invited to access the ACT program on the Manage My Pain (MMP) app. Participants will follow the instructions in the app to complete the program in a self-paced manner. The program includes psychoeducational materials, guided mindfulness meditations, and self-reflection activities.

Treatment as Usual

Other

Participants will be invited to join a one-session ACT group workshop guided by a psychologist. The session will take place virtually using video call software. The psychologist will guide participants through the workshop agenda, which will include psychoeducational material, guided mindfulness meditations, and partaking in voluntary discussions with other group members.

Other names: Psychologist-guided online ACT

Primary outcomes

  1. Feasibility of the online ACT program as assessed by the Feasibility Survey

    Time frame: Participants will be sent a link to fill out the measure within 1 week of completing their respective program.

    A 10-item Likert scale (min possible score = 10, max possible score = 70). Higher scores indicate greater feasibility.

  2. Acceptability of the online ACT program as assessed by the Treatment Evaluation Inventory - Short Form

    Time frame: Participants will be sent a link to fill out the measure within 1 week of completing their respective program.

    A 9-item Likert scale (min possible score = 9, max possible score = 45). Higher scores indicate greater acceptability.

  3. Retrospective Semi-structured Interview

    Time frame: Participants will be sent an invitation for an interview within 1 month after completing their respective program

    A brief interview with a randomized subset of participants

  4. Treatment Adherence as assessed by the Integration of ACT Skills Survey

    Time frame: Participants will be sent a link to complete the measure within 1 month after completing their respective program.

    A 5-item Likert scale (min possible score = 5, max possible score = 35). Higher scores indicate greater treatment adherence

Secondary outcomes

  1. Pain Intensity as assessed by the Pain Numerical Rating Scale

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 4-item Likert scale (min possible score = 0, max possible score = 40). Higher scores indicate greater pain intensity.

  2. Pain Interference as assessed by the PROMIS Pain Interference Scale - Short Form 8a

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 8-item Likert scale (min possible score = 8, max possible score = 40). Higher scores indicate greater pain interference.

  3. Pain Medication Misuse as assessed by the PROMIS Prescription Pain Medication Misuse Scale - Short Form 7a

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 7-item Likert scale (min possible score = 7, max possible score = 5). Higher scores indicate greater pain medication misuse.

  4. Pain Catastrophizing as assessed by the Pain Catastrophizing Scale

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 13-item Likert scale (min possible score = 0, max possible score = 52). Higher scores indicate greater pain catastrophizing.

  5. Depressive symptoms as assessed by PROMIS Emotional Distress - Depression - Short Form 8b

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 8-item Likert scale (min possible score = 8, max possible score = 40). Higher scores indicate greater depressive symptoms.

  6. Anxiety symptoms as assessed by the PROMIS Emotional Distress - Anxiety - Short Form 8A

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 8-item Likert scale (min possible score = 8, max possible score = 40). Higher scores indicate greater anxiety symptoms.

  7. Psychological Inflexibility in Pain as measured by the Psychological Inflexibility in Pain Scale

    Time frame: Participants will be sent a link to fill out the measure prior to starting their respective program, within 1 week of completing their respective program, and 1 month after completing their respective program.

    A 16-item Likert scale (min possible score = 16, max possible score = 112). Higher scores indicate greater psychological inflexibility in pain.

  8. Use of Study Platform as assessed by the Use of Manage My Pain Platform Survey

    Time frame: Participants will be sent a link to fill out the measure within 1 week of completing the respective program, and 1 month after completing their respective program.

    A 5-item Likert scale (min possible score = 4, max possible score = 20). Higher scores indicate more frequent use of the platform.

Sponsors and collaborators

Lead sponsor

University Health Network, Toronto

Other

Collaborators

  • Academic Medical Organization of Southwestern Ontario
  • Toronto General Hospital
  • York University

Registry information

Official study title

Advancing Online Psychology Tools for the Transitional Pain Service (ADOPT-TPS): Pilot Feasibility and Efficacy Randomized-Controlled Trial of a Scalable, Online Psychology Intervention for Post-Surgical Pain and Opioid Use

Acronym: ADOPT-TPS

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jun 12, 2024
Registry last updated
Apr 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.