Neer Award 2018: the effect of preoperative education on opioid consumption in patients undergoing arthroscopic rotator cuff repair: a prospective, randomized clinical trial

Background: Opioids are commonly administered for the treatment of acute and chronic pain symptoms. The current health care system is struggling to deal with increasing medication abuse and rising mortality rates from overdose. Preoperative patient-targeted education on opioid use is an avenue yet to be explored. The purpose of the study was to determine whether preoperative narcotics education reduces consumption after arthroscopic rotator cuff repair (ARCR). Methods: Patients undergoing primary ARCR at our institution were randomized to receiving opioid-related preoperative education or not. Patients filled out preoperative questionnaires detailing complete medical history and visual analog scale (VAS) for pain. Patients completed questionnaires regarding their opioid consumption and pain at their 2-week, 6-week, and 3-month follow-up. Results: The study enrolled 140 patients. Patients in the study group consumed significantly less narcotics than the control group at the 3-month follow-up. Patients in the education group were 2.2 times more likely to discontinue narcotic use by the end of follow-up (odds ratio, 2.19; P = .03). In addition, patients with a history of preoperative narcotic use that were in the education group were 6.8 times more likely to discontinue narcotics by the end of follow-up (odds ratio, 6.8; P = .008). Discussion/Conclusions: The findings of this study determined that preoperative education intervention significantly decreased the number of narcotic pills consumed at 3 months after ARCR. In addition, education resulted in earlier cessation of opioids; therefore, directed patient education can help alleviate the current opioid epidemic. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.