Evidence map›Paper›PMID 40478604›Full record

Trial reportAnesthesiology2025

A Pharmacist-partnered Opioid-tapering Service before Total Hip or Knee Arthroplasty: Qualitative Analysis of Patient Counseling Sessions.

Sophie A Young, Chi Tran, Claire E Ashton-James, Asad E Patanwala, Jennifer Stevens, Justine M Naylor, Furkan Genel, Sam Adie, Bernadette Brady, Kate Luckie and 18 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors.

Sophie A YoungFaculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia.
Chi TranFaculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia.
Claire E Ashton-JamesPain Management Research Institute, Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia.
Asad E PatanwalaFaculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia; Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Jennifer StevensSchool of Clinical Medicine, St. Vincent's Clinical Campus, University of New South Wales, Camperdown, New South Wales, Australia; University of Notre Dame, Sydney, New South Wales, Australia.
Justine M NaylorSchool of Clinical Medicine, University of New South Wales Medicine and Health, South West Sydney Clinical Campus, New South Wales, Australia.
Furkan GenelWhitlam Orthopaedic Research Centre, Ingham Institute, Liverpool, New South Wales, Australia; St. George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia.
Sam AdieSt. George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia.
Bernadette BradyDepartment of Pain Medicine, Liverpool Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Kate LuckieMaridulu Budyari Gumal Sydney Partnership of Health Education Research and Enterprise (SPHERE), Liverpool, New South Wales, Australia.
Geraldine HassettRheumatology Department, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Randwick, New South Wales, Australia.
Gilbert WhittonDrug Health Service, Fairfield Hospital Drug Health Unit, South Western Sydney Local Health District, Fairfield, New South Wales, Australia.
Joseph DescallarIngham Institute for Applied Medical Research, Liverpool, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0002-6919-4865
Frances PageCentral Coast Local Health District, Gosford, New South Wales, Australia.
Mary KeehanCentral Coast Local Health District, Gosford, New South Wales, Australia.
Cheng Fai HuiCentral Coast Local Health District, Gosford, New South Wales, Australia.ORCID 0009-0005-2256-5349
Shaniya OgulSouth Western Sydney Local Health District, Fairfield, New South Wales, Australia.
Anders G JanssonWestern New South Wales Local Health District, Orange, New South Wales, Australia.
Amy ArcherWestern New South Wales Local Health District, Orange, New South Wales, Australia.
Andrew SeftonWestern New South Wales Local Health District, Dubbo, New South Wales, Australia.
Mitchell FungWestern New South Wales Local Health District, New South Wales, Australia.
Thomas ByrnesWestern New South Wales Local Health District, New South Wales, Australia.
Geoffrey MurphyWestern New South Wales Local Health District, Blacktown, New South Wales, Australia.
Erica MorganSouth Eastern Sydney Local Health District, Caringbah, New South Wales, Australia.
Emily MayzeIllawara Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
Clare EastmentIllawara Shoalhaven Local Health District, Nowra, New South Wales, Australia.ORCID 0009-0005-6050-3843
Shania LiuFaculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia.
Jonathan PenmFaculty of Medicine and Health, School of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia; Department of Pharmacy, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrently, no literature on patients' experiences with opioid tapering before elective surgery has been published. Recent evidence indicates that tapering opioids before total hip or knee arthroplasty improves postsurgical outcomes. This study qualitatively analyzed consultation sessions of patients receiving a pharmacist-partnered opioid-tapering service before total hip or knee replacement surgery to understand their experiences and attitudes.

methodsA qualitative analysis of pharmacist counseling sessions within a randomized controlled trial was conducted. Participants were those recruited from seven hospitals between December 2021 and September 2022 who were assigned to the pharmacist-partnered opioid-tapering intervention arm of a randomized controlled trial. Consultations of participants with the pharmacist were audio-recorded and transcribed verbatim. Consultation data underwent inductive thematic analysis.

resultsConsultations were available for 20 participants, with a total of 48 audio-recorded consultations. Among these participants, four major themes including motivations to taper, knowledge and beliefs, psychosocial context, and attitudes toward tapering opioids were identified. Of the 20 participants, 70% tapered their opioids 50% or greater, with awareness of the surgery date appearing to be a key external motivating factor to taper opioids, regardless of the dose of opioids. Another notable theme was the motivation to improve fitness for participation in social activities, allowing participants to interact more with their kids and grandkids. Additionally, participant's psychosocial context revealed that factors such as stress affected their ability to taper. Pharmacists played a foundational role in shaping patients' attitudes and optimization of pain management strategies. Attitudes were identified as "optimistic," "hesitant," and "resistant," with patients displaying an optimistic attitude being more likely to taper.

conclusionsExploring the experiences of patients with osteoarthritis in a pharmacist-led opioid-tapering service before elective surgery revealed that external motivations, such as knowledge of a surgery date, play a crucial role in successful opioid tapering. Patients were more likely to taper if they knew their surgery date. Attitudes toward opioid tapering were identified as a modifiable factor. Tailoring tapering plans and patient education to individual patient contexts may enhance tapering outcomes.

Indexed as

Analgesics, OpioidArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCounselingPharmacistsPostoperative PainPreoperative CareAgedDrug TaperingFemaleHumansMaleMiddle AgedQualitative ResearchAnalgesics, Opioid

Identifiers

PMID40478604

What OpenQuestion holds

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Registered trials

None linked

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.