Evidence map›Paper›PMID 33294812›Full record

ArticleEClinicalMedicine2020

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.

Jennifer M Hah, Jodie A Trafton, Balasubramanian Narasimhan, Partha Krishnamurthy, Heather Hilmoe, Yasamin Sharifzadeh, James I Huddleston, Derek Amanatullah, William J Maloney, Stuart Goodman and 2 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02070003 (Perioperative Recovery of Moods, Opioids, and Pain Trial), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02070003 nacompletednot on this map

Perioperative Recovery of Moods, Opioids, and Pain Trial (PROMPT)

TypeinterventionalSponsorStanford UniversityRan2014 to 2018Enrolled104ConditionsOpioid CessationArmsMotivational Interviewing and Physician Guided Opioid Weaning
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Jennifer M HahDivision of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, 1070 Arastradero Rd., Suite 200, Stanford, CA 94304, United States.
Jodie A TraftonPsychiatry and Behavioral Sciences, Stanford University, Director, VA Program Evaluation and Resource Center, VHA Office of Mental Health and Suicide Prevention, Menlo Park, CA, United States.
Balasubramanian NarasimhanDepartment of Statistics, Department of Biomedical Data Sciences, Stanford University, Stanford CA, United States.
Partha KrishnamurthyDepartment of Marketing and Entrepreneurship, C. T. Bauer College of Business, University of Houston, Houston, Texas, United States.
Heather HilmoeStanford Systems Neuroscience and Pain Lab, Stanford University, Stanford, California, United States.
Yasamin SharifzadehStanford Systems Neuroscience and Pain Lab, Stanford University, Stanford, California, United States.
James I HuddlestonDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, United States.
Derek AmanatullahDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, United States.
William J MaloneyDepartment of Orthopaedic Surgery, Stanford University, United States.
Stuart GoodmanDepartment of Orthopaedic Surgery and (by courtesy) Bioengineering, Department of Orthopaedic Surgery, Stanford University, United States.
Ian CarrollDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, California, United States.
Sean C MackeyDivision of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, United States.
Stanford University · USNew York State Office of Mental Health · USUniversity of Houston · US

Funding

Psychological Risk Factors for Persistent Opioid Use and Prevention of Chronic Opioid Use and Misuse After Surgery: Postoperative Motivational Interviewing and Guided Opioid WeaningR01DA045027 · NIDA · STANFORD UNIVERSITY · PI HAH, JENNIFER · 2018 to 2022
$2.6M
Neuroimaging and Mentoring in Translational Pain ResearchK24DA029262 · NIDA · STANFORD UNIVERSITY · PI MACKEY, SEAN C · 2010 to 2019
$1.9M
NIDA NIH HHS K24 DA029262NIDA NIH HHS R01 DA045027
6 · The paper itself

Abstract

backgroundPostoperative opioid use can lead to chronic use and misuse. Few studies have examined effective approaches to taper postoperative opioid use while maintaining adequate analgesia.

methodsThis randomized, assessor-blinded, pilot trial of postoperative motivational interviewing and guided opioid tapering support (MI-Opioid Taper) added to usual care (UC) enrolled patients undergoing total hip or knee arthroplasty at a single U.S. academic medical center. MI-Opioid Taper involved weekly (to seven weeks) and monthly (to one year) phone calls until patient-reported opioid cessation. Opioid tapering involved 25% weekly dose reductions. The primary feasibility outcome was study completion in the group to which participants were randomized. The primary efficacy outcome, time to baseline opioid use, was the first of five consecutive days of return to baseline preoperative dose. Intention-to-treat analysis with Cox proportional hazards regression was adjusted for operation. ClinicalTrials.gov registration: NCT02070003.

findingsFrom November 26, 2014, to April 27, 2018, 209 patients were screened, and 104 patients were assigned to receive MI-Opioid Taper (49 patients) or UC only (55 patients). Study completion after randomization was similar between groups (96.4%, 53 patients receiving UC, 91.8%, 45 patients receiving MI-Opioid Taper). Patients receiving MI-Opioid Taper had a 62% increase in the rate of return to baseline opioid use after surgery (HR 1.62; 95%CI 1.06-2.46;

interpretationIn patients undergoing total joint arthroplasty, MI-Opioid Taper is feasible and future research is needed to establish the efficacy of MI-Opioid Taper to promote postoperative opioid cessation.

fundingNational Institute on Drug Abuse.

Indexed as

Chronic opioid use after surgeryMotivational interviewingOpioid cessationOpioid taperingOpioid tapering supportOrthopedicPain cessationPersistent postoperative opioid usepilot studyRandomized trialSurgerySurgical recoveryTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID33294812
PMCPMC7700897
OpenAlexW3093103347

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.