RecruitingPhase 4NCT06574009

Better Options for Chronic Cancer Pain

Better Options for Chronic Cancer Pain: a SMART Study


Sponsor

VA Office of Research and Development

Enrollment

294 participants

Start Date

Oct 7, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This proposal is relevant to the 240,000 cancer survivors who continue to use opioids long after they have successfully completed treatment for cancer at the VHA, placing them at risk of opioid addiction and overdose, and other opioid-related problems. Yet, there are no programs at the VHA to help them find alternatives to opioids, nor evidence to inform the choice of interventions. This study will meet these needs by examining four interventions that are effective at reducing opioid use in patients with chronic musculoskeletal pain but have yet to be tested in cancer survivors on long term opioid therapy. The proposed work is relevant to the VHA Pain Office's mission to provide Veterans better pain management while limiting the risks of long-term opioid therapy and it aligns with VHA Research and Development's priority to examine clinical interventions for tapering opioids. Successful completion this project will keep VHA at the forefront of the battle against the opioid epidemic with a strategy that may be adapted to address the same needs in non-Veterans.


Eligibility

Min Age: 18 YearsMax Age: 99 Years

Plain Language Summary

Simplified for easier understanding

This clinical trial is studying a medical device called Buprenorphine rotation, a drug called Medication optimization, and others for people with cancer survivor, chronic pain, and other related conditions. The study is currently recruiting participants at 2 locations. People eligible for this study include aged 18 Years to 99 Years.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALMultimodal pain care

Behavioral therapy (as below), physical therapy, assistive devices (e.g. TENS, bracing), referrals to VA specialists (e.g. interventional pain), and complementary and integrative therapies (e.g. acupuncture or massage

DRUGMedication optimization

Medications will be optimized following an algorithm the investigators created based upon NCCN's Survivorship Guidelines and AHRQ's comprehensive review of non-opioid treatments for chronic pain.

DEVICEBuprenorphine rotation

Subjects randomized to this arm at 6 months will be offered the chance to rotate from their full mu agonist opioid to buprenorphine using a standardized protocol

OTHEROpioid tapering

Subjects randomized to tapering will receive recommendations based upon the VA PBM's opioid tapering reference guide


Locations(2)

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, United States

VA Ann Arbor Healthcare System, Ann Arbor, MI

Ann Arbor, Michigan, United States

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NCT06574009


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