Patient perceptions of pain management and opioid use prior to hip arthroplasty

Bradley H. Lee, MD; Ejiro Gbaje, MPH; Ryan Goydos, MS; Christopher L. Wu, MD; Michael Ast, MD; Alejandro Gonzalez Della Valle, MD; Alexander McLawhorn, MD; Peter Sculco, MD; Jonathan Vigdorchik, MD; Michael Cross, MD; Seth Jerabek, MD; David Mayman, MD; Alexandra Sideris, PhD

doi:10.5055/jom.2023.0761

Authors

Bradley H. Lee, MD https://orcid.org/0000-0002-3034-1784
Ejiro Gbaje, MPH
Ryan Goydos, MS
Christopher L. Wu, MD
Michael Ast, MD
Alejandro Gonzalez Della Valle, MD
Alexander McLawhorn, MD
Peter Sculco, MD
Jonathan Vigdorchik, MD
Michael Cross, MD
Seth Jerabek, MD
David Mayman, MD
Alexandra Sideris, PhD

DOI:

https://doi.org/10.5055/jom.2023.0761

Keywords:

patient education, opioids, pain management

Abstract

Objective: Qualitative assessment investigating patients’ perceptions related to opioids including their role in pain control, risks, and handling and disposal prior to undergoing hip replacement.

Design: A prospective, cross-sectional survey study.

Setting: Large urban teaching hospital specializing in orthopedic surgery affiliated with Weill Cornell Medical College.

Participants: Patients aged 18-80, English-speaking, without recent or chronic opioid use, and planning to undergo primary total hip replacement. A total of 128 patients were enrolled and completed the study.

Intervention: A 27-item interview evaluating perceptions on opioid-related topics.

Main outcome measures: Responses to interview questions were documented by research assistant.

Results: Most patients believe that there should be minimal or no pain with the use of opioids, though they also agree that opioids should be limited to pain that interferes with function or activity. Patients generally appreciate risks of addiction with opioids but are less familiar with risks associated with sleep apnea and sedatives. Minority of patients understand that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in combination with opioids would effectively reduce pain. Majority of patients were unsure of how to properly store and dispose of opioids.

Conclusions: Qualitative assessment demonstrates that patients may benefit from education and discussion specifically about pain expectations, the role of opioids in treating pain, multimodal analgesia, and proper storage and disposal.

Author Biographies

Bradley H. Lee, MD

Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; Department of Anesthesiology, Weill Cornell Medicine, New York, New York

Ejiro Gbaje, MPH

Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York

Ryan Goydos, MS

Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York

Christopher L. Wu, MD

Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; Department of Anesthesiology, Weill Cornell Medicine, New York, New York