ArticleArchives of physical medicine and rehabilitation2021
Association of Occupational and Physical Therapy With Duration of Prescription Opioid Use After Hip or Knee Arthroplasty: A Retrospective Cohort Study of Medicare Enrollees.
Article in Archives of physical medicine and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Characteristics of Early Interventions for Pain and Function Following Lower Extremity Joint Replacement: Systematic Review.Occupational therapy in health care · 2023Pooled it
- Primary care provider attitudes regarding physical therapists addressing opioid use and opioid misuse: a qualitative study.Physical therapy · 2026Article
- The value of a preoperative physical therapy and home evaluation program in total joint arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Prediction Model for Factors Associated With Long-Term Opioid Use Following Total Knee Arthroplasty: A Retrospective Population-Based Study.European journal of pain (London, England) · 2026Article
- Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee-for-service claims.Journal of the American Geriatrics Society · 2025Article
- Racial Disparities in Outpatient Physical Therapy Use After Hip Fracture: A Retrospective Cohort StudyThe Journal of orthopaedic and sports physical therapy · 2024Article
- Pain Control Associated With Gabapentinoid Prescription After Elective Total Knee Arthroplasty.The Journal of arthroplasty · 2024Article
- Inequitable access to nonpharmacologic pain treatment providers among cancer-free U.S. adults.Preventive medicine · 2024Article
- Optimal Duration of Physical Therapy Following Total Knee Arthroplasty.Geriatric orthopaedic surgery & rehabilitation · 2024Article
- Pain and incident cognitive impairment in very old Mexican American adults.Journal of the American Geriatrics Society · 2024Article
- The Impact of High- Versus Low-Dose Home Rehabilitation for Functional Independence after Hip or Knee Replacement.Journal of the American Medical Directors Association · 2024Article
- Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019.JAMA network open · 2022Article
- Incident Functional Limitations Among Community-Dwelling Adults Using Opioids: A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study.Drugs & aging · 2022Article
- Opioid and Benzodiazepine Substitutes: Impact on Drug Overdose Mortality in Medicare Population.The American journal of medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo establish whether nonpharmacologic interventions, such as occupational and physical therapy, were associated with a shorter duration of prescription opioid use after hip or knee arthroplasty.
designThis retrospective cohort study used data from a national 5% Medicare sample database between January 1, 2010 and December 31, 2015.
settingHome health or outpatient.
participantsAdults 66 years or older with an inpatient total hip (n=4272) or knee (n=9796) arthroplasty (N=14,068).
interventionsWe dichotomized patients according to whether they had received any nonpharmacologic pain intervention within 1 year after hospital discharge (eg, occupational or physical therapy evaluation). Using Cox proportional hazards, we treated exposure to nonpharmacologic interventions as time dependent to determine if skilled therapy was associated with duration of opioid use.
main outcome measuresDuration of prescription opioid use.
resultsMedian time to begin nonpharmacologic interventions was 91 days (95% confidence interval [CI], 74-118d) for hip and 27 days (95% CI, 27-28d) for knee arthroplasty. Median time to discontinue prescription opioids was 16 days (hip: 95% CI, 15-16d) and 30 days (knee: 95% CI, 29-31d). Nonpharmacologic interventions delivered with home health increased the likelihood of discontinuing opioids after hip (hazard ratio [HR], 1.15; 95% CI, 1.01-1.30) and knee (HR, 1.10; 95% CI, 1.03-1.17) arthroplasty. A sensitivity analysis found these estimates to be robust and conservative.
conclusionsOccupational and physical therapy with home health was associated with a shorter duration of prescription opioid use after hip and knee arthroplasty. Occupational and physical therapy can address pain and sociobehavioral factors associated with postsurgical opioid use.
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Registered trials
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