• Beth D Darnall, Sean C Mackey, Kate Lorig, Ming-Chih Kao, Aram Mardian, Richard Stieg, Joel Porter, Korina DeBruyne, Jennifer Murphy, Luzmercy Perez, Heather Okvat, Lu Tian, Pamela Flood, Mark McGovern, Luana Colloca, Heather King, Brent Van Dorsten, Ting Pun, and Matthias Cheung.
• Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
• Pain Med. 2020 Aug 1; 21 (8): 1523-1531.

ObjectiveEvidence to date, while sparse, suggests that patients taking long-term opioids require special considerations and protections to prevent potential iatrogenic harms from opioid de-prescribing, such as increased pain or suffering. Following this study protocol, the EMPOWER study seeks to address multiple unmet needs of patients with chronic pain who desire to reduce long-term opioid therapy, and provide the clinical evidence on effective methodology.MethodsEMPOWER applies patient-centered methods for voluntary prescription opioid reduction conducted within a comprehensive, multi-state, 3-arm randomized controlled comparative effectiveness study of three study arms (1) group cognitive behavioral therapy for chronic pain; (2) group chronic pain self-management; and (3) usual care (taper only). Specialized electronic data capture systems collect patient reported symptoms and satisfaction data weekly and monthly during the taper, with real-time clinical alerts and electronic feedback loops informing, documenting, and steering needed care actions.ConclusionThe EMPOWER study seeks to provide granular evidence on patient response to voluntary opioid tapering, and will provide evidence to inform clinical systems changes, clinical care, patient satisfaction, and patient outcomes for opioid reduction.© 2019 American Academy of Pain Medicine.

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