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Patient, family and healthcare worker advisory council of lowering opiate utilization in ICU by using NSAID analgesics: a KETOROLac at Lower reduced doses for Analgesic pain Control in ICU (KETOROLAC-ICU) study

Background
A mainstay of analgesia provision for critically ill patients has been opiates for pain control. Prior observational studies demonstrate that over 80% of mechanically ventilated patients use opiates. However, opiate use can be fraught with side effects including: delirium, constipation, hypopneas/apnea. Increased rates of opiate use in hospital lead to increased prescription-based opiate dependence following intensive care unit (ICU) discharge. This may contribute to the ongoing opiate epidemic across the world with increased tolerance and addiction to these medications, with potential consequences of higher opiate related overdoses.
Other adjunctive medications exist, including non-steroidal anti-inflammatory drugs (NSAIDs) which block cyclooxygenases (COX) and this can work to block decrease pain, fever and inflammation. Traditionally, NSAIDs have been avoided in ICU patients due to the theoretical increased risk of gastrointestinal (GI) bleeding and risk of acute kidney injury (AKI). It is unclear whether patients, families and ICU healthcare providers consider opiate use reduction a patient-important outcome.
Because of this, we are proposing a qualitative study using a modified Delphi approach to learn if opiate use reduction using other analgesic adjuncts in adult critically ill patients is a patient-important outcome.

Roles and Responsibilities
This project is looking for patient partners with lived experience of the ICU to assist in determine if reduced opiate use in ICU is a patient-important outcome; if it is a worthwhile research endeavour with meaningful results to patients and potentially an important outcome in multi-centered randomized control trials. The project outcomes can benefit patient health including reducing the risk of opiate tolerance, addiction and/or dependence post-ICU. This can also lead to faster weaning of analgesic medications in ICU patients, potentially decreased delirium, reducing pain sores, potentially reduce time on ventilators, and reduce ICU length of stay.
Patient partners will be asked to join in working and discussion groups as research team members, contributing their insights, perspectives and lived experience expertise to help determine patient-important outcomes (e.g. pain control, opiate exposure) through a modified Delphi process. This will include voting and giving feedback on various outcomes of importance for patients and families.

Time Commitment
This project anticipates to start as soon as possible, and continue until about June 2023.
Patient partner collaboration will include 2-3 Zoom meeetings (1-2 hours long) along with email correspondence.

Compensation/Reimbursement
This is a volunteer opportunity. Should the project become funded, compensation will be discussed.
This is an online opportunity, there are no expenses anticipated with travel and parking.

For more information or to apply
Vincent Lau
Vince.lau@ualberta.ca
780.492.9390