Table 1.
Qualitative synthesis of high-quality studies included in the systematic review
| Author | Population | Intervention | Comparator | Outcome | Study design | Results and conclusion | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Admiraal et al.[24] (TRUSt) | 176 patients at risk for CPSP | TPS | Standard of care | Quality of recovery (primary) Opioid consumption |
RCT | Short-term outcomes are not affected Might improve long-term outcomes. Decreased opioid use |
||||||
| Liang et al.[25] | 95 patients with ankylosing spondylitis | Nurse-led multidisciplinary transitional care | Routine nursing care | Clinical outcomes (short form 36) and quality of life | RCT | Improved clinical outcomes and quality of life | ||||||
| Wang and Wu[26] | 156 patients undergoing cancer pain management | Transitional care model in cancer pain management | Standard care | Pain score Quality of life Patient satisfaction Adequacy of opioids |
RCT | Reduction in pain scores, higher satisfaction and quality of life and adequacy of opioids | ||||||
| Abid Azam et al.[27] | 382 patients undergoing multidisciplinary TPS to manage CPSP | ACT as part of multidisciplinary TPS | No ACT | Behavioural pain management and opioid consumption | RCT | ACT as part of TPS resulted in reduced opioid use, improved mood and pain interference/catastrophising | ||||||
| Featherall et al.[28] | 208 patients undergoing total joint arthroplasty | TPS | Historical control | Opioid use at 90 days (primary) Postoperative outcome scores and opioid consumption (secondary) |
RCT | TPS resulted in a reduction in opioid prescription consumption, leading to a reduction in persistent opioid use | ||||||
| Clarke et al.[29] | 251 high-risk TPS patients | TPS among opioid naïve | TPS among opioid experience | Opioid use, opioid weaning rate and pain management | POS | Successful opioid weaning in 50% of opioid naïve and 25% of opioid experienced | ||||||
| Hussain et al.[30] | 86 patients | Tele-TPS among opioid-naïve and exposed patients | Opioid tapering CBT achieving TPS efficacy on persistent opioid use and pain/behavioural outcomes | POS | 100% efficacy in opioid tapering among opioid naïve and in 52% among opioid exposed | |||||||
| Haynes et al.[31] | 31 paediatric patients | To evaluate the risk factors and clinical features of PPSP in a paediatric complex pain service after introduction of TPS | TPS-based intervention | ROS | TPS-based non-pharmacological strategies and conservative use of opioids by TPS are the best ways of preventing PPSP | |||||||
| Buys et al.[32] | Observational study among 336 veterans undergoing major joint surgery | To evaluate the reduction in opioid use by TPS | TPS reduced the onset of new chronic opioid use | ROS | Implementation of TPS resulted in opioid consumption and opioid weaning among preexisting opioid users | |||||||
| Buys et al.[33] | Observational study among 213 veterans undergoing orthopaedic surgery | To evaluate reduction in opioid usage by TPS among 72% opioid naïve | Evaluate opioid usage by TPS among 28% chronic opioid users | TPS as an emerging concept in perioperative surgical home concept | ROS | Multidisciplinary TPS for veteran population decreased by 40% without affecting the pain intensity and physical function | ||||||
| Huang et al.[34] | Single-centre, observational cohort study on 200 APS patients by telephonic interview | To evaluate the incidence of PPSP and persistent opioid use utilising the pain disability index, brief pain inventory and health outcome questionnaire- EuroQol 5 Dimension 5 Level (EQ-5D-5L) | APS–TPS combination to evaluate opioid usage | Postoperative opioid use is associated with lower mood and functional interference, leading to pain-related daily life disability | POS | Utility of TPS in modifying pain trajectories and effective opioid weaning | ||||||
| Montbriand et al.[35] | Retrospective study of 239 patients | Association of smoking status and pain along with opioid use | Non-smokers | Higher pain intensities and opioid consumption among smokers are associated with higher pack-years | ROS | TPS-initiated smoking cessation as a modifiable risk for opioid use after surgery | ||||||
| Liu et al.[36] | Prospective cohort study among 279 patients undergoing thoracic surgery | To evaluate pain trajectories among elective thoracic surgery patients until 1 year after surgery | Regional anaesthesia techniques and psychological assessed interventions for reducing pain catastrophising | Pain-related outcomes and complications among three subgroup pain trajectories constituted as mild or moderate and associated with pain catastrophising | POS | Higher preoperative pain catastrophising and occurrence of immediate postoperative pain progress to severe CPSP | ||||||
| Yu et al.[37] | TPS retrospective cohort study among 140 patients undergoing solid organ transplant surgery | Opioid consumption, pain catastrophising and psychological attributes evaluated | TPS in transplantation surgery evaluated | Association between opioid consumption, psychological characteristics and pain incorporating psychology and physiotherapy | ROS | Treatment by the multidisciplinary TPS team was associated with significant improvement in pain severity and a reduction in opioid consumption |
ACT=acceptance and commitment therapy, APS=acute pain service, CBT=cognitive behavioural therapy, CPSP=chronic postsurgical pain, POS=observational studies based on prospective cohort population, PPSP=persistent postsurgical pain, RCT=randomised controlled trial, ROS=observational studies based on mixed cohort population, TPS=transitional pain service