Clinical trial NCT04059055: Decreasing Unused Opioids in the Home Post Supracondylar Fracture Repair
Official title: Decreasing Unused Opioids in the Home Post Supracondylar Fracture Repair
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain Management
Lead sponsor: The Hospital for Sick Children
Sponsor class: OTHER
First posted: 2019-08-16
Enrollment: 175
Sex: ALL
Minimum age (years): 0
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Any child (0-18 years) who has undergone a supracondylar fracture repair at The Hospital for Sick Children.

Brief summary: Over the past two decades, the misuse of prescription opioids has significantly increased. A recent systematic review reported as much as 67% to 92% of opioids dispensed on discharge post-surgery go unused. This culture of overprescribing is consistently observed across surgical specialties. Less frequently observed is the potential for opioid use and misuse in children and adolescents post-surgery. The research to date in this area has been poorly performed with heterogenous data collection, analysis and reporting, as well as large loss of patients to follow-up.

The investigators' previous prospective observational deception study identified three areas of concern:

1. There is a culture of postoperative opioid over-prescribing at discharge as demonstrated by heterogenous opioid dosing and duration of treatments across practitioners for single procedures
2. This overprescribing is in excess of patients' home-requirements and results in significant quantities of leftover opioids
3. There is a culture of inappropriate storage and lack of safe disposal of prescribed opioids in the community

Detailed description: This study focuses on addressing and minimizing pediatric surgical over-prescribing. It aims to reduce the amount of opioids prescribed by focusing prescribers and families on regular use of simple non-opioid analgesics, as well as decreasing the amount of opioids prescribed and dispensed.

Eligibility criteria: Inclusion Criteria:

* Patients with supracondylar fractures undergoing surgical wire placement or pinning that return to fracture clinic at three weeks for removal of pins/wires.
* Patients discharged on the weekday.
* Families filling a prescription for opioids at Shoppers Drug Mart at SickKids Hospital.
* Parent has strong command of the English language (i.e., no interpreter required).

Exclusion Criteria:

* Patients with a history of chronic pain.
* Patient used opioid medication within the previous 6 months.
* Patients who are discharged on the weekend (as participant emails will need to be entered into redcap the day of recruitment, for data collection to commence the next morning).

Primary outcomes:
measure: Pain medication use questionnaire
timeFrame: 3 days following discharge from hospital
Secondary outcomes:
measure: Amount of opioid returned
timeFrame: 3 weeks following discharge (aligns with pin/wire removal at fracture clinic)
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
Study officials:
affiliation: Staff Anesthesiologist
name: Conor Mc Donnell
role: PRINCIPAL_INVESTIGATOR
References: