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I-WOTCH: Improving the Wellbeing of people with Opioid Treated CHronic pain

Seeking GP practices to host I-WOTCH study on opioid withdrawal for chronic pain

We are currently recruiting GP practices within Birmingham Cross City CCG, Dudley CCG and Herefordshire CCG to take part in the I-WOTCH study. We are a multi-centre, randomised controlled trial aiming to test the effectiveness and cost effectiveness of a multicomponent self-management intervention targeting withdrawal of strong opioids for people living with persistent pain in comparison to best usual care. The chief investigator for the study is Dr Harbinder Sandhu at the Clinical Trials Unit, University of Warwick.

We plan to recruit 468 participants from around 200 general practices, community pain/musculoskeletal services and pharmacies across two locations: the Midlands and North East England

The I-WOTCH intervention is targeting patients using Buprenorphine, Dipipanone, Morphine, Diamorphine, Fentanyl, Methadone, Oxycodone, Papavertum, Pentazocine, Pethidine, Tapentadol, or Tramadol for the treatment of persistent non-cancer pain. These drugs account for 95 per cent of UK strong opioid prescribing in primary care.

What will it involve for participants?

All participants will be asked to:

· Provide written consent and complete postal questionnaires at baseline, four, eight and 12 months

· Complete a weekly diary booklet recording symptoms and quality of life for four months from baseline

Participants will be randomised to either:

· Usual GP care plus a self-learning manual

Participants will receive a manual with advice about chronic pain management and potential implications and adverse effects of using opioids, and a relaxation CD plus usual GP care

·  Usual GP care plus a support programme

Participants will attend a three day self-management course led by an I-WOTCH nurse and a lay facilitator held at a venue close to their practice. There will be an average of 12 people in a group. Participants will have two one-to-one meetings and two telephone calls with the nurse. The nurse will create an opioid tapering plan for the participant at the first meeting and then monitor and discuss their progress over the calls and final one-to-one meeting. Participants will receive the self-learning manual, relaxation CD, educational DVD and mindfulness CD plus their usual GP care

What will it involve for GP practices?

· Identification of potential participants from computer record search

· Checking of list before mail-out

· Mail out of study invitation letters (via Docmail)

· Access to patient records at a later date for data collection of consultations, health service activity, prescriptions and NHS number