TY - JOUR
T1 - Perioperative Opioid Counseling Reduces Opioid Use Following Primary Total Joint Arthroplasty
AU - Carender, Christopher N.
AU - Anthony, Christopher A.
AU - Rojas, Edward O.
AU - Noiseux, Nicolas O.
AU - Bedard, Nicholas A.
AU - Brown, Timothy S.
N1 - Copyright © The Iowa Orthopaedic Journal 2022.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - BACKGROUND: Preoperative 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).METHODS: Participants 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.RESULTS: 183 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).CONCLUSION: Perioperative opioid counseling significantly decreases the quantity and duration of opioid consumption at 6 weeks following primary TJA.
Level of Evidence: I.
AB - BACKGROUND: Preoperative 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).METHODS: Participants 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.RESULTS: 183 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).CONCLUSION: Perioperative opioid counseling significantly decreases the quantity and duration of opioid consumption at 6 weeks following primary TJA.
Level of Evidence: I.
KW - counseling
KW - opioid
KW - total hip arthroplasty
KW - total knee arthroplasty
KW - Opioid-Related Disorders/drug therapy
KW - Analgesics, Opioid/therapeutic use
KW - Humans
KW - Counseling
KW - Arthroplasty, Replacement, Knee
KW - Pain, Postoperative/drug therapy
UR - http://www.scopus.com/inward/record.url?scp=85133947337&partnerID=8YFLogxK
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M3 - Article
C2 - 35821950
AN - SCOPUS:85133947337
SN - 1555-1377
VL - 42
SP - 169
EP - 177
JO - The Iowa orthopaedic journal
JF - The Iowa orthopaedic journal
IS - 1
ER -