Jeffrey G. Stepan
LAS VEGAS — Implementation of a standardized education program significantly reduced opioid intake after hand surgery, decreased refill rates and improved patient satisfaction, according to results presented at the American Society for Surgery of the Hand Annual Meeting.
Jeffrey G. Stepan, MD, MSc, and colleagues randomly assigned 267 patients undergoing non-minor elective hand surgery to either an education group or control group. Preoperatively, the education group viewed an interactive webinar regarding postoperative pain management, while the control group viewed a webinar describing methods for logging postoperative pill consumption and pain without the educational component. Researchers also provided a postoperative pain card to patients in the education group. After surgery, all patients completed a postoperative log and completed surveys reviewing medication use and satisfaction on postoperative days 3, 8 and 15.
Overall, Stepan noted the final analysis included 191 patients, with age being the only difference in patient demographics. Patients in the education group took significantly fewer pills and had a lower refill rate compared with patients in the standard of care group, according to Stepan.
“With regard to our primary outcomes, we were surprised that 42% of patients did not take any opioids in the education group, which was a significantly more proportion of patients than the standard of care group,” Stepan said.
He added there were fewer dissatisfied patients with pain management in the education group, and both groups maintained approximately the same pain levels after surgery.
“In terms of predictors of opioid use, after controlling for demographics and certain variables, we saw patient education, number of opioid pills prescribed [and] patient history of psychiatric disease were all predictors of opioid use,” Stepan said. – by Casey Tingle
Stepan JG, et al. Abstract 4. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 5-7, 2019; Las Vegas.
Disclosure: Stepan reports no relevant financial disclosures.