Decreasing Unused Opioids in the Home Post Supracondylar Fracture Repair

Over the past two decades, the misuse of prescription opioids has significantly increased. A recent systematic review reported as much as 67% to 92% of opioids dispensed on discharge post-surgery go unused. This culture of overprescribing is consistently observed across surgical specialties. Less frequently observed is the potential for opioid use and misuse in children and adolescents post-surgery. The research to date in this area has been poorly performed with heterogenous data collection, analysis and reporting, as well as large loss of patients to follow-up.

The investigators' previous prospective observational deception study identified three areas of concern:

1. There is a culture of postoperative opioid over-prescribing at discharge as demonstrated by heterogenous opioid dosing and duration of treatments across practitioners for single procedures
2. This overprescribing is in excess of patients' home-requirements and results in significant quantities of leftover opioids
3. There is a culture of inappropriate storage and lack of safe disposal of prescribed opioids in the community

Study Overview

• Status: Completed
• Conditions: Pain Management

Detailed Description

This study focuses on addressing and minimizing pediatric surgical over-prescribing. It aims to reduce the amount of opioids prescribed by focusing prescribers and families on regular use of simple non-opioid analgesics, as well as decreasing the amount of opioids prescribed and dispensed.

• Study Type: Observational
• Enrollment (Actual): 175

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5G 1X8
      • The Hospital for Sick Children

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 second to 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Any child (0-18 years) who has undergone a supracondylar fracture repair at The Hospital for Sick Children.

Description

Inclusion Criteria:

• Patients with supracondylar fractures undergoing surgical wire placement or pinning that return to fracture clinic at three weeks for removal of pins/wires.
• Patients discharged on the weekday.
• Families filling a prescription for opioids at Shoppers Drug Mart at SickKids Hospital.
• Parent has strong command of the English language (i.e., no interpreter required).

Exclusion Criteria:

• Patients with a history of chronic pain.
• Patient used opioid medication within the previous 6 months.
• Patients who are discharged on the weekend (as participant emails will need to be entered into redcap the day of recruitment, for data collection to commence the next morning).

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain medication use questionnaire	Recording of how many pain meds were used at home	3 days following discharge from hospital

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Amount of opioid returned	Recording of how much opioid was returned to the hospital	3 weeks following discharge (aligns with pin/wire removal at fracture clinic)

Collaborators and Investigators

• Sponsor: The Hospital for Sick Children
• Investigators: Principal Investigator: Conor Mc Donnell, Staff Anesthesiologist

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2019
• Primary Completion (Actual): September 30, 2020
• Study Completion (Actual): September 30, 2020

Study Registration Dates

• First Submitted: August 14, 2019
• First Submitted That Met QC Criteria: August 14, 2019
• First Posted (Actual): August 16, 2019

Study Record Updates

• Last Update Posted (Actual): December 17, 2021
• Last Update Submitted That Met QC Criteria: December 16, 2021
• Last Verified: December 1, 2021

More Information

Terms related to this study

• Other Study ID Numbers: 1000064960

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No