Impact of a Behavioral Tele-health Program on the Quality of Recovery for Patients Undergoing Total Joint Replacement Surgery

Impact of Daily, Digital and Behavioral Tele-health Tapering Program for Perioperative Surgical Patients Exposed to Opioids.

The quality of recovery after surgery is multi-factorial and includes both physical and mental factors. Persistent pain after surgery is a common problem after major surgery and can result in persistent opioid use. The investigators will be evaluating if the addition of a pain coach/councilor before and after surgery, through a tele health platform (LucidLane) can improve participant's recovery from major joint surgery.

Inclusion Criteria:

• Male or female patients between the ages of 21-90 years old
• Patient is opioid naive i.e hasn't used opioid medication for 30 days prior to surgery
• Patient willing to use Lucid Lane program to provide behavioral health support for up to 4 weeks before surgery and 4 weeks after surgery.
• Patient is willing to discuss Lucid Lane progress with Palo Alto VA's medical team and prescribing clinicians.
• Patient is willing to sign a Lucid Lane Client Agreement.
• Patient is willing to sign an informed consent form

Exclusion Criteria:

• Serious mental illnesses including schizophrenia-spectrum disorders, severe bipolar disorder, and severe major depression.
• Active suicidal ideations
• Patient is on methadone or buprenorphine for treatment of opioid use disorder(i.e. for treatment of addiction, and not for treatment of pain)
• Patient unwilling to use or not possessing access to a device that allows for video visits(e.g. a smart phone, tablet, or computer)
• Patients who are in palliative care
• Unable to use English to participate in the consent process, the intervention or study assessments.
• Unable to provide informed consent to participate