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Arthropathy of KneeNCT05593341

Opioid Education in Total Knee Arthroplasty

A study testing Opioid education in person and Opioid education via video in people with Arthropathy of Knee and Post Operative Pain, run by Hospital for Special Surgery, New York at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Does perioperative education pathway reduce opioid refill requests? 2. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Opioid education in person and Opioid education via video
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 siteUnited States
Study dates
27 Sep 2022to 11 Sep 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

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

Who cannot join

  • 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)
Show all 10Show fewer
  • Contraindication or refusal to receive neuraxial anesthesia or peripheralnerve blocks (PNB)
  • Revision surgery
  • Ambulatory surgery
  • Patients who are pregnant

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Hospital for Special Surgery

    New York, New York, 10021

Other trials in United States

About this study

Official title: Effect of Perioperative Opioid Education on Outcomes After Total Knee Arthroplasty: A Randomized Study

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. Does perioperative education pathway reduce opioid refill requests?
  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. Is there a difference between education provided in-person vs video?
  4. Does perioperative education improve compliance with multimodal analgesia?
  5. Does perioperative education improve appropriate opioid storage?
  6. Does perioperative education improve appropriate opioid disposal?
Read more

Enrolled patients will be assigned at random to one of 3 study groups. Group 1 (control): Patients are referred to the hospital's standard 1-hour virtual patient education webinar prior to surgery.

Group 2 (in-person): Patients will receive two in-person education sessions (1st session before surgery and 2nd session after surgery). Patients will also receive portable document format (pdf) handouts about opioid and pain management.

Group 3 (video): Patients will receive two video education sessions (1st session before surgery and 2nd session after surgery). Patients will also receive pdf handouts about opioid and pain management.

Read the detailed description

Patients undergoing surgery are frequently unaware of how to properly use opioids for pain management which may result in poor compliance with pain regimens, worse pain control and functional outcomes, and improper storage and disposal. There is evidence that educational interventions in various formats may improve pain and promote proper opioid handling. In addition, multimodal analgesia has been shown to be effective in total joint arthroplasty, and setting appropriate expectations may reduce anxiety, postoperative recovery time, and post surgical acute pain.

The current education process at HSS involves patient referral to a virtual webinar which is optional. Pain topics are covered within a broader 50-minute presentation on numerous topics related to surgery. Information on pain topics may be difficult to process and retain because it is a single exposure that is combined with multiple unrelated topics, and there is no repetition or reference provided. The aim of this study is to explore how a comprehensive educational pathway focusing on aspects of pain control and proper opioid use with repeated sessions will affect outcomes after total knee arthroplasty by comparing three groups - 1) patients who attend the virtual webinar, 2) an in-person session with a portable document format (PDF), and 3) a video session with PDF.

Being tested
Opioid education in person, Opioid education via video
Keywords
Opioid Education
Medical subject headings
Pain, Postoperative, Opioid-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Opioid education in personOther

    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
  • Opioid education via videoOther

    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
Study groups in NCT05593341
Study groupRoleWhat they receive
Control GroupNo interventionPatients are referred to the Hospital's standard 1-hour virtual patient education webinar prior to surgery.
In-person and PDFExperimentalPatients 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.
Receives: Other: Opioid education in person
Video and PDFExperimentalPatients 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.
Receives: Other: Opioid education via video

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Opioid refill at POD 30

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

    Measured: Post operative day (POD) 30

  2. Opioid refill at POD 60

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

    Measured: Post operative day (POD) 60

Secondary outcomes (7)
  1. Hospital length of stay

    The total amount of time spent in-patient following their surgery.

    Measured: 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)

  2. Patient's health and recovery status following their surgery

    A survey titled: quality of recovery 15 (QoR15) is a patient- reported outcome measure measuring quality of recovery after surgery and anesthesia.

    Each of the following question on the survey will be assessed on a 0-10 scale, with 0 meaning "none of the time" and 10 meaning "all of the time".

    How have you been feeling in the last 24 hours?

    1. Able to breathe easily
    2. Been able to enjoy food
    3. Feeling rested
    4. Have had a good sleep
    5. Able to look after personal toilet and hygiene unaided
    6. Able to communicate with family or friends
    7. Getting support from hospital doctors and nurses
    8. Able to return to work or usual home activities
    9. Feeling comfortable and in control
    10. Having a feeling of general well-being Have you had any of the following in the last 24 hours?
    11. Moderate pain
    12. Severe pain
    13. Nausea or vomiting
    14. Feeling worried or anxious
    15. Feeling sad or depressed

    Measured: 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

  3. Numerical Rating Scale

    Patients are asked to report a number between 0 and 10 that best measures their pain intensity. Zero represents 'no pain at all' whereas 10 represents 'the worst pain ever possible'.

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

  4. Opioid consumption

    The amount of opioid consumption by the patient (in oral morphine equivalents).

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

  5. Rates of compliance with multimodal regimen

    Patients will keep "pain diary" to record use of each medication (acetaminophen, NSAIDs, and opioid). Compliance will be defined as the percentage of prescribed medication (acetaminophen or NSAID) that is actually taken.

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

  6. Rates of proper opioid storage

    Patients will be asked to report how they are storing their opioids (i.e., stored "locked and hidden").

    Measured: Post-operative day 7

  7. Rates of proper opioid disposal

    Patients will be asked to report how they are disposing of their unused opioids (i.e., reporting they dispose using one of the accepted proper disposal methods).

    Measured: Post-operative day 21

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Oct 2022
  2. Study start27 Sep 2022
  3. Primary completion11 Sep 2023
  4. Study completion11 Sep 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05593341
Sponsor's protocol ID
2022-1286
Status last verified
Dec 2024
First submitted
30 Sep 2022
Last updated
27 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no plan to make IPD available to other researchers.

Publications

  • 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.

    PubMed 31567320
  • 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.

    PubMed 29599038
  • 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.

    PubMed 32285282
  • 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.

    PubMed 31335400
  • 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.

    PubMed 29498951
  • 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.

    PubMed 33235041
  • 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.

    PubMed 32251139
  • 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.

    PubMed 16079372
  • 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.

    PubMed 39327049

Questions about this trial

What is this clinical trial studying?

A study testing Opioid education in person and Opioid education via video in people with Arthropathy of Knee and Post Operative Pain, run by Hospital for Special Surgery, New York at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Opioid refill at POD 30 (time frame: Post operative day (POD) 30). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05593341, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Dec 2024.

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