A systematic review of patient-centered interventions for improving pain outcomes and reducing opioid-related risks in acute care settings.

• Type of Material: Article
• Authors: Jesse Seilern Und Aspang, Emory University; Mara Schenker, Emory University; Ada Port, Christopher Wolf Crusade; Sharon Leslie, Emory University; Nicholas Giordano, Emory University
• Language: English
• Date: 2023-03
• Publisher: Wolters Kluwer Health, Inc
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/OI9.0000000000000226
• Title of Journal or Parent Work: OTA Int
• Volume: 6
• Issue: 1
• Start Page: e226
• End Page: e226
• Grant/Funding Information: This work was supported, in part by, the Injury Prevention Research Center at Emory (NCIPC R49 CE003072).
• Keywords: patient-centered intervention; outcomes; pain management; orthopaedic trauma; opioids
• Research Categories: Health Sciences, Pharmacology; Health Sciences, Medicine and Surgery

Abstract

OBJECTIVES: This systematic review evaluates the literature for patient-oriented opioid and pain educational interventions that aim to optimize pain management using opioid-sparing approaches in the orthopaedic trauma population. The study protocol was registered with PROSPERO (CRD42021234006). DATA SOURCES: A review of English-language publications in CINAHL (EBSCO), MEDLINE through PubMed, Embase.com, PsycInfo (EBSCO), and Web of Science Core Collection literature databases published between 1980 and February 2021 was conducted using PRISMA guidelines. STUDY SELECTION: Only studies implementing patient-oriented opioid and/or pain education in adult patients receiving acute orthopaedic care were eligible. Outcomes were required to include postinterventional opioid utilization, postoperative analgesia and amount, or patient-reported pain outcomes. DATA EXTRACTION: A total of 480 abstracts were reviewed, and 8 publications were included in the final analysis. Two reviewers independently extracted data from selected studies using a standardized data collection form. Disagreements were addressed by a third reviewer. Quality of studies was assessed using the Cochrane Risk of Bias Tool. DATA SYNTHESIS: Descriptive statistics characterized study findings, and content analysis was used to discern themes across studies. CONCLUSION: Our findings indicate the merit for patient-centered educational interventions including verbal/written/audio-visual trainings paired with multimodal approaches to target opioid-sparing pain management and reduce short-term pain scores in urgent and acute care settings after acute orthopaedic injuries. The scarcity of published literature warrants further rigorously designed studies to substantiate the benefit of patient-centric education in reducing prolonged opioid utilization and associated risks after orthopaedic trauma. LEVEL OF EVIDENCE: Therapeutic level III.