Trial reportThe American journal of managed care2018
A randomized, pragmatic, pharmacist-led intervention reduced opioids following orthopedic surgery.
Trial report in The American journal of managed care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Effect of pharmacist care on clinical outcomes and therapy optimization in perioperative settings: A systematic review.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024Pooled it
- Pooled it
- Improving medication safety in the perioperative setting: development of a medication use process.British journal of anaesthesia · 2025Article
- Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis.Therapeutic advances in drug safety · 2024Article
- The effect of pharmacist-initiated perioperative multidisciplinary pharmaceutical care model and clinical pathway on pain management in patients undergoing orthopedic surgery: a before-after study.International journal of clinical pharmacy · 2023Article
- A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute care settings.OTA international : the open access journal of orthopaedic trauma · 2023Article
- Bedside check of medication appropriateness (BED-CMA) as a risk-based tool for bedside clinical pharmacy services: A proof-of-concept study at the trauma surgery ward.Computational and structural biotechnology journal · 2023Article
- Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist.Anesthesiology · 2022Article
- Strategies aimed at preventing long-term opioid use in trauma and orthopaedic surgery: a scoping review.BMC musculoskeletal disorders · 2022Article
- Article
- Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial.EClinicalMedicine · 2020Article
- Innovative patient education and pain management protocols to achieve opioid-free shoulder arthroplasty.JSES international · 2020Article
- A Pharmacist-Led Program to Taper Opioid Use at Kaiser Permanente Northwest: Rationale, Design, and Evaluation.The Permanente journal · 2020Article
- Article
- Factors associated with opioid-tapering success: A mixed methods study.Journal of the American Pharmacists Association : JAPhAArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo determine whether a pharmacist-led, patient-directed intervention can reduce opioid use following total hip arthroplasty (THA) or total knee arthroplasty (TKA). STUDY
designRandomized trial.
methodsPatients scheduled to undergo THA or TKA (during 2015 and 2016) were randomized to usual care or intervention. We ranked patients according to predicted risk of persistent opioid use and selected the top 60% for inclusion (n = 561); all contributed to the analysis. Intervention patients were mailed materials 2 weeks before and after surgery, plus they received telephone intervention from specially trained pharmacists if they filled opioid prescriptions in the 28 to 90 days following surgery. Our primary outcome was the dispensed morphine equivalents (DME) in the 90 days following surgery, modeled using a natural log transformation.
resultsA total of 561 patients were randomized (286 usual care, 118 THA and 168 TKA; 275 intervention, 107 THA and 168 TKA); the mean age was 66 years, and 60% were female. Overall, we found no meaningful reduction in DME for intervention versus usual care (geometric mean ratio, 0.92 [95% CI, 0.69-1.21]). However, there was effect modification by whether the patient had TKA or THA (interaction P <.01). Those undergoing THA in the intervention group used significantly less DME than did those undergoing THA in the usual care group (geometric mean ratio, 0.52 [95% CI, 0.33-0.82]).
conclusionsOur pharmacist-led, patient-directed intervention to reduce opioid use demonstrated a reduction in opioid dispensings in the 90 days following THA but not TKA.
Indexed as
Identifiers
30452208PMC13326298W2988382536What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.