Multimodal Analgesic Regimen for Total Hip Arthroplasty: An Initiative to Minimize Postoperative Opioid Use
Henry Ford Health System
Summary
This study examines whether patients undergoing total hip replacement surgery can manage their pain effectively while using fewer opioid pain medications. Participants will be randomly assigned to one of two groups. The first group will receive the standard postoperative pain medication regimen, with all prescriptions sent directly to their pharmacy as usual. The second group will receive the same medications, but their opioid prescription will only be provided as a printed copy rather than being sent directly to the pharmacy, requiring them to choose whether to fill it. All participants will keep a pain journal and complete questionnaires about their medication intake over the first 21 days post-op as well as there function and wellbeing at follow up visits over 3 months. The goal is to determine whether this approach reduces opioid use while still adequately controlling pain after hip replacement surgery.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adult patients age 18 and older * Patients who have undergone total hip arthroplasty by a single, fellowship trained Orthopaedic Surgeon. Exclusion Criteria: * Patients with incomplete data in medical records * Chronic opioid use in the last 3 months * Ipsilateral joint surgery in the last year * Cannot tolerate oral medications * Swallowing difficulties * Intolerance to Tylenol, Celebrex, Robaxin, Neurontin, or Tramadol * History of Alcohol abuse * History of Drug abuse * History of Renal impairment * History of Peptic ulcer disease * History of GI bleeding * Illicit…
Interventions
- DrugStandard Multimodal Analgesic Regimen with Opioid Prescription
Participants receive the standard postoperative multimodal pain regimen following primary total hip arthroplasty. All prescriptions are sent directly to the patient's pharmacy. Opioid consumption tracked via the Michigan Automated Prescription System (MAPS) and patient medication journal. Pain and medication consumption are assessed via daily pain/medication logs daily for the first week, then weekly for two additional weeks.
- BehavioralOpioid-Reduced Multimodal Analgesic Regimen with Printed Prescription
Participants receive the standard postoperative multimodal pain regimen following primary total hip arthroplasty. Tramadol is prescribed but the prescription is printed and given to the patient rather than sent to the pharmacy, requiring the patient to actively choose to fill it. This behavioral barrier is designed to reduce opioid consumption while preserving patient autonomy. Pain and medication intake is assessed via daily pain journals and medication logs for the first week, then weekly for two additional weeks. Opioid consumption is also tracked via the Michigan Automated Prescription System (MAPS).
Location
- Henry Ford HospitalDetroit, Michigan