Journal article
Perioperative Opioid Counseling Reduces Opioid Use Following Primary Total Joint Arthroplasty
The Iowa orthopaedic journal, Vol.42(1), pp.169-177
06/01/2022
PMCID: PMC9210409
PMID: 35821950
Appears in Diamond Open Access
Abstract
BackgroundPreoperative counseling may reduce postoperative opioid requirements; however, there is a paucity of randomized controlled trials (RCTs) demonstrating efficacy. The purpose of this study was to perform an interventional, telehealth-based RCT evaluating the effect of peri-operative counseling on quantity and duration of opioid consumption following primary total joint arthroplasty (TJA). MethodsParticipants were randomized into three groups: 1. Control group, no perioperative counseling; 2. Intervention group, preoperative educational video; 3. Intervention group, preoperative educational video and postoperative acceptance and commitment therapy (ACT). Opioid consumption was evaluated daily for 14 days and at 6 weeks postoperatively. Best-case and worse-case intention to treat analyses were performed to account for non-responses. Bonferroni corrections were applied. Results183 participants were analyzed (63 in Group 1, 55 in Group 2, and 65 in Group 3). At 2 weeks postoperatively, there was no difference in opioid consumption between Groups 1, 2, and 3 (p>0.05 for all). At 6 weeks postoperatively, Groups 2 and 3 had consumed significantly less opioids than Group 1 (p=0.04, p<0.001) (Table 1). Group 3 participants were less likely to obtain an opioid refill relative to Group 1 participants (p=0.04). Participants in groups 2 and 3 ceased opioid consumption a median of 6 days and 2 days sooner than Group 1, respectively (p<0.001, p=0.03) (Table 2). ConclusionPerioperative opioid counseling significantly decreases the quantity and duration of opioid consumption at 6 weeks following primary TJA. Level of Evidence: I.
Details
- Title: Subtitle
- Perioperative Opioid Counseling Reduces Opioid Use Following Primary Total Joint Arthroplasty
- Creators
- Christopher N CarenderChristopher A AnthonyEdward O RojasNicolas O NoiseuxNicholas A BedardTimothy S Brown
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.42(1), pp.169-177
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 35821950
- PMCID
- PMC9210409
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304696902771
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