A Multidisciplinary Transitional Pain Management Program Is Associated With Reduced Opioid Dependence After Primary Total Joint Arthroplasty

Featherall, Joseph; Anderson, Lucas A.; Bayless, Kimberlee; Anderson, Zachary; Brooke, Benjamin S.; Gililland, Jeremy M.; Buys, Michael J.

doi:10.1016/j.arth.2022.02.032

Cited by 21 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Multidisciplinary transitional pain services, including a diverse team of clinicians, who perform comprehensive pain evaluations and offer multimodal pain management approaches are becoming more common to help manage acute exacerbations of pain in ED or perioperative settings. 23 Psychological factors, which have been consistently associated with greater pain, may serve as rational targets for intervention. 25,41,43 From a clinical perspective, evaluating and openly discussing patients' concerns about the underlying cause of their pain may decrease pain-related catastrophic thoughts.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Daily pain and opioid administration in hospitalized patients with cancer: the importance of psychological factors, recent surgery, and current opioid use

Azizoddin

Wilson

Flowers

et al. 2023

Pain

View full text Add to dashboard Cite

Pain is common and variable in its severity among hospitalized patients with cancer. Although biopsychosocial factors are well established as modulators of chronic pain, less is known about what patient-level factors are associated with worse pain outcomes among hospitalized cancer patients. This prospective cohort study included patients with active cancer presenting to the emergency department (ED) with pain severity of ≥4/10 and followed pain outcomes longitudinally throughout hospital admission. Baseline demographic, clinical, and psychological factors were assessed on ED presentation, and daily average clinical pain ratings and opioid consumption during hospitalization were abstracted. Univariable and multivariable generalized estimating equation analyses examined associations of candidate biopsychosocial, demographic, and clinical predictors with average daily pain and opioid administration. Among 113 hospitalized patients, 73% reported pain as the primary reason for presenting to the ED, 43% took outpatient opioids, and 27% had chronic pain that predated their cancer. Higher pain catastrophizing (B = 0.1, P ≤ 0.001), more recent surgery (B = −0.2, P ≤ 0.05), outpatient opioid use (B = 1.4, P ≤ 0.001), and history of chronic pain before cancer diagnosis (B = 0.8, P ≤ 0.05) were independently associated with greater average daily pain while admitted to the hospital. Higher pain catastrophizing (B = 1.6, P ≤ 0.05), higher anxiety (B = 3.7, P ≤ 0.05), lower depression (B = −4.9, P ≤ 0.05), metastatic disease (B = 16.2, P ≤ 0.05), and outpatient opioid use (B = 32.8, P ≤ 0.001) were independently associated with higher daily opioid administration. Greater psychological distress, especially pain catastrophizing, as well as pain and opioid use history, predicted greater difficulty with pain management among hospitalized cancer patients, suggesting that early assessment of patient-level characteristics may help direct consultation for more intensive pharmacologic and nonpharmacologic interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Daily pain and opioid administration in hospitalized patients with cancer: the importance of psychological factors, recent surgery, and current opioid use

Azizoddin

Wilson

Flowers

et al. 2023

Pain

View full text Add to dashboard Cite

show abstract

“…Similar results have been reported in orthopedic trauma patients, as well as those who underwent shoulder arthroplasty [21] . On a national level, similar studies have shown decreases in opioid prescriptions and consumption across multiple orthopedic subspecialties secondary to opioid limiting legislation [ [22] , [23] – 24 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of the Florida law HB21 on opioid prescribing patterns after spine surgery

Geller

Milner

Pandya

et al. 2023

North American Spine Society Journal (NASSJ)

View full text Add to dashboard Cite

“…Some studies have indicated that TPS is effective in alleviating postoperative pain and in reducing opioid use after discharge [107,108]. Recent reports also suggest that implementing TPS for various surgical patients resulted in a substantial reduction in the severity of CPSP and opioid consumption after discharge [109][110][111][112]. Moreover, implementing TPSs is expected to be economically feasible by reducing the social costs associated with CPSP, such as loss of productivity and treatment expenses [113].…”

Section: Tpsmentioning

confidence: 99%

Practical strategies for the prevention and management of chronic postsurgical pain

2023

View full text Add to dashboard Cite

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

show abstract

A Multidisciplinary Transitional Pain Management Program Is Associated With Reduced Opioid Dependence After Primary Total Joint Arthroplasty

Cited by 21 publications

References 36 publications

Daily pain and opioid administration in hospitalized patients with cancer: the importance of psychological factors, recent surgery, and current opioid use

Daily pain and opioid administration in hospitalized patients with cancer: the importance of psychological factors, recent surgery, and current opioid use

The impact of the Florida law HB21 on opioid prescribing patterns after spine surgery

Practical strategies for the prevention and management of chronic postsurgical pain

Contact Info

Product

Resources

About