Opioid Education in Total Knee Arthroplasty

NCT05593341 | Completed

• 1 other identifier: 2022-1286
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this experimental study is to compare different education intervention on opioid education for patients undergoing total knee arthroplasty. The specific research questions to address are:

1. 1.Does perioperative education pathway reduce opioid refill requests?
2. 2.Is education pathway that focuses on pain management provided in-person and via video in repeated sessions more effective than current standard of care education consisting of a single exposure given as part of a broader preoperative presentation covering multiple topics?
3. 3.Is there a difference between education provided in-person vs video?
4. 4.Does perioperative education improve compliance with multimodal analgesia?
5. 5.Does perioperative education improve appropriate opioid storage?
6. 6.Does perioperative education improve appropriate opioid disposal?

Conditions

Arthropathy of Knee; Post Operative Pain; Opioid Use; Opioid Abuse; Opioid Misuse

Keywords

Opioid Education

Outcome Measures

Primary Outcomes (2)

• Opioid refill at POD 30

  Patients will be asked if they have refilled their opioid prescription and the number of opioid refills.

  Post operative day (POD) 30

• Opioid refill at POD 60

  Patients will be asked if they have refilled their opioid prescription and the number of opioid refills.

  Post operative day (POD) 60

Secondary Outcomes (7)

• Hospital length of stay

  From the time patient enters the post-anesthesia care unit (PACU entry) until the time patient is discharged from the hospital (discharge time), assessed up to 168 hours (1 week)

• Patient's health and recovery status following their surgery

  Pre-operative (when patient is in the holding area being prepped for surgery), Post-operative day 1, Post-operative day 7, Post-operative day 14

• Numerical Rating Scale

  Post-operative day 0, Post-operative day 1, Post-operative day 7, Post-operative day 14

• Opioid consumption

  Post-operative day 0, Post-operative day 1, Post-operative day 7, Post-operative day 14

• Rates of compliance with multimodal regimen

  Post-operative day 1, Post-operative day 7, Post-operative day 14

Study Arms (3)

Control Group

NO INTERVENTION

Patients are referred to the Hospital's standard 1-hour virtual patient education webinar prior to surgery.

In-person and PDF

EXPERIMENTAL

Patients will receive two in-person education sessions (1st session before surgery and 2nd session after surgery). Patients will also receive pdf handouts about opioids and pain management.

Other: Opioid education in person

Video and PDF

EXPERIMENTAL

Patients will receive two video education sessions (1st session before surgery and 2nd session after surgery). Patients will also receive pdf handouts about opioids and pain management.

Other: Opioid education via video

Interventions

Opioid education in person OTHER

The presentation and handouts contain information regarding the following topics: * Reviewing opioids and strategies for analgesia * Defining and identifying opioids * Goals for postoperative pain management and utilizing opioids to treat pain * Alternative modes of treating pain * Regional anesthesia/analgesia defined * Side effects and risks of opioids * Common side effects of opioids * Risks of addiction, tolerance, dependence, opioid-induced hyperalgesia with long-term use * Proper use and handling of opioids * Safe practices when taking opioids * Weaning off opioids * Safe storage and disposal of opioids

In-person and PDF

Opioid education via video OTHER

The video and handouts contain information regarding the following topics: * Reviewing opioids and strategies for analgesia * Defining and identifying opioids * Goals for postoperative pain management and utilizing opioids to treat pain * Alternative modes of treating pain * Regional anesthesia/analgesia defined * Side effects and risks of opioids * Common side effects of opioids * Risks of addiction, tolerance, dependence, opioid-induced hyperalgesia with long-term use * Proper use and handling of opioids * Safe practices when taking opioids * Weaning off opioids * Safe storage and disposal of opioids

Video and PDF

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between age 18 and 80 years old
• Undergoing primary total knee replacement surgery at Hospital for Special Surgery
• English speaking

You may not qualify if:

• History of chronic opioid use (continuous opioid use for 3 or more months)
• Opioid use within the past 3 months
• Contraindication to NSAIDs or acetaminophen
• Contraindication or allergy to opioids
• Contraindication to any study medications (i.e., fentanyl, ketamine, versed, acetaminophen, ketorolac, zofran, decadron)
• Discharge to rehab or skilled nursing facility (opioids are not prescribed by HSS providers)
• Contraindication or refusal to receive neuraxial anesthesia or peripheralnerve blocks (PNB)
• Revision surgery
• Ambulatory surgery
• Patients who are pregnant

Sponsors & Collaborators

• Hospital for Special Surgery, New York: lead

Study Sites (1)

Hospital for Special Surgery

New York, New York, 10021, United States

Location

Related Publications (9)

• Lee BH, Wu CL. Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review. Anesth Analg. 2020 Mar;130(3):574-581. doi: 10.1213/ANE.0000000000004436.

  PMID: 31567320 RESULT

• Syed UAM, Aleem AW, Wowkanech C, Weekes D, Freedman M, Tjoumakaris F, Abboud JA, Austin LS. Neer Award 2018: the effect of preoperative education on opioid consumption in patients undergoing arthroscopic rotator cuff repair: a prospective, randomized clinical trial. J Shoulder Elbow Surg. 2018 Jun;27(6):962-967. doi: 10.1016/j.jse.2018.02.039. Epub 2018 Mar 26.

  PMID: 29599038 RESULT

• Egan KG, De Souza M, Muenks E, Nazir N, Korentager R. Opioid Consumption Following Breast Surgery Decreases with a Brief Educational Intervention: A Randomized, Controlled Trial. Ann Surg Oncol. 2020 Sep;27(9):3156-3162. doi: 10.1245/s10434-020-08432-7. Epub 2020 Apr 13.

  PMID: 32285282 RESULT

• Horn A, Kaneshiro K, Tsui BCH. Preemptive and Preventive Pain Psychoeducation and Its Potential Application as a Multimodal Perioperative Pain Control Option: A Systematic Review. Anesth Analg. 2020 Mar;130(3):559-573. doi: 10.1213/ANE.0000000000004319.

  PMID: 31335400 RESULT

• Memtsoudis SG, Poeran J, Zubizarreta N, Cozowicz C, Morwald EE, Mariano ER, Mazumdar M. Association of Multimodal Pain Management Strategies with Perioperative Outcomes and Resource Utilization: A Population-based Study. Anesthesiology. 2018 May;128(5):891-902. doi: 10.1097/ALN.0000000000002132.

  PMID: 29498951 RESULT

• Stepan JG, Sacks HA, Verret CI, Wessel LE, Kumar K, Fufa DT. Standardized Perioperative Patient Education Decreases Opioid Use after Hand Surgery: A Randomized Controlled Trial. Plast Reconstr Surg. 2021 Feb 1;147(2):409-418. doi: 10.1097/PRS.0000000000007574.

  PMID: 33235041 RESULT

• Nahhas CR, Hannon CP, Yang J, Gerlinger TL, Nam D, Della Valle CJ. Education Increases Disposal of Unused Opioids After Total Joint Arthroplasty: A Cluster-Randomized Controlled Trial. J Bone Joint Surg Am. 2020 Jun 3;102(11):953-960. doi: 10.2106/JBJS.19.01166.

  PMID: 32251139 RESULT

• Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. doi: 10.1056/NEJMra050100. No abstract available.

  PMID: 16079372 RESULT

• Sheetz M, Puglisi A, Trentalange M, Reichel J, Chalmers B, Gonzalez Della Valle A, Sideris A, Lee BH. Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial. Reg Anesth Pain Med. 2026 Jan 5;51(1):60-68. doi: 10.1136/rapm-2024-105701.

  PMID: 39327049 DERIVED

MeSH Terms

Conditions

Pain, Postoperative; Opioid-Related Disorders

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Narcotic-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders

Study Officials

• Bradley H Lee, MD

  Hospital for Special Surgery, New York

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 30, 2022
• First Posted: October 25, 2022
• Study Start: September 27, 2022
• Primary Completion: September 11, 2023
• Study Completion: September 11, 2023
• Last Updated: December 27, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)