Table 1 TOPP-Trauma Sessions

Educational - 1

The week prior to hospital discharge

- The various components of pain (introduction to the biopsychosocial dimensions of pain and how they negatively or positively influence pain experience)

- How to assess pain intensity

- Adequate use of analgesics prescribed

- Need to taper opioids to prevent abuse and dependence

- How to use cryotherapy

Educational - 2

The week prior to hospital discharge

- How to use deep breathing relaxation exercises

- The need to stay active

- How to establish objectives for staying active with the SMART^a procedure (establish an objective with the participant)

- The influence of sleep hygiene on pain and the characteristics of an adequate sleep hygiene

- The strategies to achieve adequate sleep hygiene

Counseling - 1

One week after hospital discharge

- Assessment of patient’s average pain intensity at rest and upon movement in the last 48 h

- Follow up on activity objective

- Assessment of analgesics taken over the last 72 h.

- Assessment of non-pharmacological pain management strategies used over the last 72 h and underscoring the importance of using these strategies.

- Providing information on how to gradually reduce the consumption of analgesics (e.g., 25% opioid dose reduction OR decrease frequency of opioid use, e.g., every 6 h instead of every 3–4 h OR before activities causing high-intensity pain) if pain < 4/10 and does not interfere with activities.

- Assisting the participant to establish an objective for staying active according to the SMART procedure to be met in 2 weeks.

Counseling - 2

Two weeks after counseling session 1

- Assessment of patient’s average pain intensity at rest and upon movement in the last 48 h

- Follow up on activity objective

- Assessment of analgesics taken over the last 72 h.

- Assessment of non-pharmacological pain management strategies used over the last 72 h and underscoring the importance of using these strategies

- Providing information on how to gradually reduce the consumption of analgesics (e.g., 25% opioid dose reduction OR decrease frequency of opioid use, e.g., every 8 h instead of every 6 h OR before activities causing high-intensity pain) if pain < 4/10 and does not interfere with activities.

- Assisting the participant to establish an objective for staying active.

Counseling - 3

Two weeks after counseling session 2

- Same as counseling sessions 1 and 2.

- Providing information on how to gradually reduce the consumption of analgesics (e.g., 25% opioid dose reduction OR decrease frequency of opioid use, e.g., every 10-12 h instead of every 8 h OR before activities causing high-intensity pain) if pain < 4/10 and does not interfere with activities.

Counseling - 4, 5 and 6

Two weeks after counseling session 3, 4, 5

- Same as counseling sessions 1 to 3.

- Providing information on how to gradually reduce the consumption of analgesics (i.e., no need to take opioids on a regular basis unless specified by her/his physician; to rely principally on acetaminophen to manage their pain and to use opioids only in the presence of pain interfering with activities not relieved by other strategies).

- Encouraging the patient to consult her/his physician and providing a list of support resources for substance abuse if still taking opioids at counseling session 6.