Opioid Education in Total Knee Arthroplasty
Condition: Arthropathy of Knee; Post Operative Pain; Opioid Use; Opioid Abuse; Opioid Misuse
MeSH terms: Pain, Postoperative; Opioid-Related Disorders
Study type: Interventional

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. 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?

      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.
    

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.
    

Intervention name(s): Opioid education in person; Opioid education via video
Intervention type(s): Other; Other
Intervention description(s): 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; 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
Intervention MeSH terms: Analgesics, Opioid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Opioid Education