Developing an Opioid Taper Intervention Before Total Joint Arthroplasty

University of Alabama at Birmingham45 enrolled

Overview

The goal of this clinical trial is to develop an pharmacist-led preoperative opioid taper intervention for patients undergoing total knee or hip replacement who are on chronic opioids before their surgery. The main questions it aims to answer are: * Is the intervention feasible and acceptable to patients? * Does the intervention result in a decrease in opioid dose during the preoperative period? Participants will meet with a clinical pharmacist, who will provide some basic education on pain and opioids, and will propose an opioid taper schedule. The pharmacist will then follow-up with the participant by phone each week until surgery to assess progress and adjust the taper as necessary.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Arthritis Knee Arthritis Hip Chronic Pain

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * decided to pursue primary, unilateral total knee or hip arthroplasty with planned surgery date in 4-8 weeks * currently taking between 20 and 90 MME of oral opioids, and that dose has been stable for at least 3 months * have a reliable telephone number for contact * speaks English Exclusion Criteria: * Taking opioid medications that include: * Buprenorphine * Methadone * Long-acting formulations of opioid pain medications (e.g., extended-release oxycodone and extended-release morphine) * Transdermal formations of opioid pain medications (e.g., fentanyl patches)

Outcomes

Primary Outcomes

Acceptability

Mixed-methods assessment of the intervention by participants. Participants will provide qualitative feedback at multiple points during and after the intervention, and will quantitatively rate satisfaction at the end of the study. These results will be analyzed jointly to determine acceptability.

Time frame: From enrollment until approximately 2 weeks after surgery

Secondary Outcomes

Study Recruitment Rate

In order to assess feasibility of the taper intervention, we will track the proportion of participants who are offered enrollment that ultimately enroll (will be measured separately for those offered enrollment in person and those who are mailed information about the study)

Time frame: From enrollment until approximately 2 weeks after surgery

Study Retention Rate

In order to assess feasibility of the taper intervention, we will track the proportion of enrolled participants who complete the final study visit.

Time frame: From enrollment until approximately 2 weeks after surgery

Taper Efficacy

change in opioid dose from enrollment through surgery

Time frame: From enrollment until the time of surgery

Perioperative Pain

pain scores throughout the perioperative period

Time frame: From enrollment until approximately 2 weeks after surgery

Developing an Opioid Taper Intervention Before Total Joint Arthroplasty

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts