Prolonged Opioid Use After Primary Total Knee and Total Hip Arthroplasty: Prospective Evaluation of Risk Factors and Psychological Profile for Depression, Pain Catastrophizing, and Aberrant Drug-Related Behavior

Sheth, Dhiren S.; Ho, Ngoc; Pio, Jose R.; Zill, Peggy; Tovar, Stephanie; Namba, Robert S.

doi:10.1016/j.arth.2020.07.008

Cited by 24 publications

(23 citation statements)

References 40 publications

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“…Previous studies have reported some conflicting outcomes on this topic. A previous study by Sheth et al [20] also failed to identify a clear association between depression and pain catastrophizing with post-operative opioid use in TKA and THA patients. Similarly, a study by Dunn et al [21] also failed to find an association among anxiety, depression, and pain catastrophizing with post-operative opioid use in patients undergoing spine surgery.…”

Section: Discussionmentioning

confidence: 89%

Predicting Post-Discharge Opioid Consumption After Total Hip and Knee Arthroplasty in the Opioid-Naïve Patient

Debbi

Krell

Sapountzis

et al. 2022

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 89%

Predicting Post-Discharge Opioid Consumption After Total Hip and Knee Arthroplasty in the Opioid-Naïve Patient

Debbi

Krell

Sapountzis

et al. 2022

The Journal of Arthroplasty

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“…We identified that patients were required to wait longer for their surgery (88-day difference in median wait time from referral to follow-up), and a significantly larger proportion of patients were prescribed opioid-based analgesia (14 percentage points more in the COVID-19 group compared with our historical Controls) preoperatively, despite a lower frequency of opioid use at referral. Given the previously known associations between preoperative opioid use and poorer perioperative surgical outcomes, [9][10][11][12][13][14] urgent attention is required to identify alternative effective non-operative treatment strategies or expedite operative intervention for those awaiting arthroplasty surgery. Increasing use of opioid medication routinely within this healthcare setting may also have larger long-term consequences for public health.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on opioid use in those awaiting hip and knee arthroplasty: a retrospective cohort study

et al. 2021

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BackgroundCOVID-19 has had a detrimental impact on access to hip and knee arthroplasty surgery. We set out to examine whether this had a subsequent impact on preoperative opioid prescribing rates for those awaiting surgery.MethodsData regarding patient demographics and opioid utilisation were collected from the electronic health records of included patients at a large university teaching hospital. Patients on the outpatient waiting list for primary hip and knee arthroplasty as of September 2020 (COVID-19 group) were compared with historical controls (Controls) who had previously undergone surgery. A sample size calculation indicated 452 patients were required to detect a 15% difference in opioid prescription rates between groups.ResultsA total of 548 patients (58.2% female) were included, 260 in the COVID-19 group and 288 in the Controls. Baseline demographics were similar between the groups. For those with data available, the proportion of patients on any opioid at follow-up in the COVID-19 group was significantly higher: 55.0% (143/260) compared with 41.2% (112/272) in the Controls (p=0.002). This remained significant when adjusted for confounding (age, gender, Scottish Index of Multiple Deprivation, procedure and wait time). The proportion of patients on a strong opioid was similar (4.2% (11/260) vs 4.8% (13/272)) for COVID-19 and Controls, respectively. The median waiting time from referral to follow-up was significantly longer in the COVID-19 group compared with the Controls (455 days vs 365 days; p<0.0001).ConclusionThe work provides evidence of potential for an emerging opioid problem associated with the influence of COVID-19 on elective arthroplasty services. Viable alternatives to opioid analgesia for those with end-stage arthritis should be explored, and prolonged waiting times for surgery ought to be avoided in the recovery from COVID-19 to prevent more widespread opioid use.

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“… 32 Our study shows that differential access to postoperative opioids also exists for patients with LEP undergoing TKA and that this difference cannot be explained by confounding factors such as higher postoperative pain levels or history of preoperative opioid use, which are known strong predictors of postoperative opioid use. 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Language barriers and postoperative opioid prescription use after total knee arthroplasty

Nguyen¹,

Rambachan²,

Ward³

et al. 2022

Exploratory Research in Clinical and Social Pharmacy

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Prolonged Opioid Use After Primary Total Knee and Total Hip Arthroplasty: Prospective Evaluation of Risk Factors and Psychological Profile for Depression, Pain Catastrophizing, and Aberrant Drug-Related Behavior

Cited by 24 publications

References 40 publications

Predicting Post-Discharge Opioid Consumption After Total Hip and Knee Arthroplasty in the Opioid-Naïve Patient

Predicting Post-Discharge Opioid Consumption After Total Hip and Knee Arthroplasty in the Opioid-Naïve Patient

Impact of COVID-19 on opioid use in those awaiting hip and knee arthroplasty: a retrospective cohort study

Language barriers and postoperative opioid prescription use after total knee arthroplasty

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