Shared Decision Aid for Post-Total Knee Arthroplasty Opioid Prescribing

Launched by BRIGHAM AND WOMEN'S HOSPITAL · Sep 21, 2020

Keywords

ClinConnect Summary

This study will be a randomized controlled trial for primary, unilateral total knee arthroplasty (TKA) patients at Brigham and Women's Faulkner Hospital, Brigham and Women's Hospital and University of Chicago Medical Center to determine the impact of using a SDA on the number of leftover opioid pills on postoperative day 30 and average NRS pain score on postoperative day 7.

The SDA includes factual information about the World Health Organization pain ladder, the 0-10 NRS pain scale, pharmacologic pain management options, opioid medication benefits and risks and predicted post-discharge opi...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Primary unilateral TKA under spinal anesthesia at Brigham \& Women's Faulkner Hospital (BWFH), Brigham and Women's Hospital or University of Chicago Medical Center by a participating surgeon
• • \>18 years of age
• * Planned discharge with the typical analgesic medications prescribed at discharge:
• • standing around-the clock Tylenol with or without an NSAID
• • tramadol PRN
• • hydromorphone (dilaudid) or oxycodone PRN
• Exclusion Criteria:
• • Diagnosis of dementia
• • \<18 years old
• • Contraindication or allergy to opioids
• • Contraindication or allergy to Tylenol
• • Contraindication or allergy to gabapentin
• • History of substance use disorder
• • Preoperative pain requiring a \>1-month prescription for \>/=45 daily MMEs
• • 4 or more preoperative analgesic prescriptions
• • Hospital admission \>1 day
• • Discharge to a skilled nursing facility/inpatient rehabilitation center
• • Non-English speaking patients
• • Requirement for general anesthesia intra-operatively