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One of the most challenging issues in modern medicine is the current opioid epidemic. Given the association between opioid use after surgery and the development of opioid addiction, an essential goal of the medical community should be to develop strategies aimed at instructing the safe use of opioids. In addition, instructions on how to use non-opioid painkillers and exercises and techniques to better cope with pain can be used to reduce the patients opioid requirements after surgery. This study aims to evaluate the effect of providing an online educational video presentation to patients prior to surgery. This will be a 30 minute video which will provide the study participants with instructions on how best to use their opioid and non-opioid medication for pain and also teach the study participants exercises and techniques to better cope with their pain. This intervention will be used with a view to reduce the amount of opioids used by patients following hip or knee replacement surgery. Participants will be followed during their immediate phase after surgery to determine how much pain killers the participants have used and at six weeks the participants will be asked to return their unused opioids to see how much the participants have used in total.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Opioid Counseling and PCS Video Group | Experimental | This arm of the study will receive the opioid counseling and pain coping skills video 2 weeks prior to their surgery in addition to the conventional information provided to all patients undergoing total joint arthroplasty. |
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| Standard of Care Group | No Intervention | This arm of the study will the conventional information provided to all patients undergoing total joint arthroplasty. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Opioid Counseling and Pain Coping Skills Video | Other | The intervention will be in the form of a video of a PowerPoint presentation with instructions and exercises designed to coach patients about catastrophizing, coping skills, mindfulness and behavioral modification techniques, in addition to providing education regarding postoperative analgesia and opioid use. |
| Measure | Description | Time Frame |
|---|---|---|
| Post operative opioid consumption | Total opioid consumption during the first 72 hours following THA or TKA surgery, measured in oral morphine equivalents. | From surgery until 72 hours postoperatively. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain | Using the Visual Analog Scale (VAS) for Pain Assessment from 0 to 10 with 0 being no pain and 10 being extreme pain. | On postoperative days 1/2/3, and 1- and 6-week follow-up. |
| Length of hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sunnybrook Health Sciences Centre | Toronto | Ontario | M4N 3M5 | Canada |
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| ID | Term |
|---|---|
| D010358 | Patient Participation |
| ID | Term |
|---|---|
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
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Length of Stay from day of hospital admission to day of hospital discharge.
| From day of admission until 72 hours postoperatively. |
| Time to first opioid demand dose | The number of hours from the time of surgery to the participants requesting their first opioid dose, either in the post-anesthesia care unit or the ward. | In the first 24 hours after surgery. |
| Post-operative complication rate | The incidence of postoperative complications, including events possibly related to opioid consumption. | 24 hours after surgery, and 1/6 week follow-ups. |
| Total opioid consumption at 6-week follow-up | The total opioid consumption, reported at the 6 week follow-up. | 6 weeks after surgery. |
| Need for rescue opioid breakthrough therapy | The need for rescue opioid breakthrough therapy in the first 24 hours after surgery, assessed as a binary (yes/no) outcome. | From surgery until 24 hours postoperatively. |
| Participant Compliance | Participant compliance, defined as whether or not participants in the experimental group viewed the study video. | Day of surgery |
| Participant satisfaction at baseline | Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire. | Baseline (up to 1 week before surgery). |
| Participant satisfaction at 1 week | Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire. | 1 week after surgery. |
| Participant satisfaction at 6 weeks | Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire. | 6 weeks after surgery. |