The James A. Rand Young Investigator's Award: Large Opioid Prescriptions Are Unnecessary After Total Joint Arthroplasty: A Randomized Controlled Trial

The Journal of Arthroplasty
Charles P HannonCraig J Della Valle

Abstract

The purpose of this randomized controlled trial is to determine whether the quantity of opioid pills prescribed at discharge is associated with the number of opioid pills consumed or unused by patients after primary hip and knee arthroplasty within 30 days after discharge. A total of 304 opioid-naïve patients were randomized to receive either 30 or 90 5-mg oxycodone immediate-release (OxyIR) pills at discharge. Daily opioid consumption, number of unused pills, and pain scores were calculated for 30 days with a patient-completed medication diary. Statistical analysis involved t-test, rank-sum, chi-squared tests, and multiple linear regression with alpha = 0.05. Of the 304 patients randomized, 161 patients were randomized to receive 30 pills and 143 to receive 90. In the first 30 days after discharge, the median number of unused pills was 15 in the 30 group vs 73 in the 90 group (P < .001). Within 90 days of discharge, 26.7% of the 30 group and 10.5% of the 90 group requested a refill (P < .001), leading to a mean of 777.1 ± 414.2 morphine equivalents vs 1089.7 ± 536.4 prescribed (P < .0001). There was no difference between groups in mean morphine equivalents consumed. Regression analysis demonstrated that being prescribed 90 Oxy...Continue Reading

Citations

Apr 7, 2020·The Journal of Bone and Joint Surgery. American Volume·Cindy R NahhasCraig J Della Valle
May 20, 2020·Orthopaedic Journal of Sports Medicine·Francis LovecchioJo Hannafin
Aug 8, 2019·Clinical Orthopaedics and Related Research·Daniel B C ReidAlan H Daniels
Dec 3, 2020·The Journal of Bone and Joint Surgery. American Volume·Michael J Taunton
Jul 11, 2020·Journal of Shoulder and Elbow Surgery·Daniel J CunninghamMark J Gage
Oct 1, 2019·The Journal of Bone and Joint Surgery. American Volume·Mengnai Li, Andrew Glassman
Sep 6, 2020·Journal of Orthopaedic Trauma·Daniel J CunninghamMark J Gage
Jul 8, 2021·The Journal of Bone and Joint Surgery. American Volume·Joseph A KaramJavad Parvizi
Aug 5, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Celeste A MallamaTamra Meyer
Sep 30, 2021·Substance Abuse Treatment, Prevention, and Policy·Daniel J CunninghamBrian D Lewis
Mar 31, 2021·Clinical Spine Surgery : a Spine Publication·Francis LovecchioTodd Albert

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