Effect of a Pre-operative Internet-based Educational Video on Post Operative Opioid Consumption

Effect of a Pre-operative Internet-based Educational Video, Providing Both Opioid Counselling and Pain Coping Skills, on Post-operative Opioid Consumption

One of the most challenging issues in modern medicine is the current opioid epidemic. Given the association between opioid use after surgery and the development of opioid addiction, an essential goal of the medical community should be to develop strategies aimed at instructing the safe use of opioids. In addition, instructions on how to use non-opioid painkillers and exercises and techniques to better cope with pain can be used to reduce the patients opioid requirements after surgery. This study aims to evaluate the effect of providing an online educational video presentation to patients prior to surgery. This will be a 30 minute video which will provide the study participants with instructions on how best to use their opioid and non-opioid medication for pain and also teach the study participants exercises and techniques to better cope with their pain. This intervention will be used with a view to reduce the amount of opioids used by patients following hip or knee replacement surgery. Participants will be followed during their immediate phase after surgery to determine how much pain killers the participants have used and at six weeks the participants will be asked to return their unused opioids to see how much the participants have used in total.

Study Overview

• Status: Active, not recruiting
• Conditions: Patient Empowerment
• Intervention / Treatment: Other: Opioid Counseling and Pain Coping Skills Video

• Study Type: Interventional
• Enrollment (Estimated): 220
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M4N 3M5
      • Sunnybrook Health Sciences Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients must be adults (> 18 years of age) undergoing knee or hip arthroplasty.
• Patients will be ASA 1-3 undergoing elective surgery.
• English speaking patients with internet and computer access at home will be included.
• Patients with pre-existing psychological conditions who receive either pharmaceutical or talk-based therapy will be included.
• Patients must meet a minimum cognitive capacity to understand the instructions for the Opioid Counseling and Pain Coping Skills presentation. This will be assessed by the administration of the Montreal Cognitive Assessment during screening (MoCA), whereby a minimum score of 18 will be required to meet inclusion into the study.

Exclusion Criteria:

• Significant cognitive impairment.
• Chronic pain, long-term opioid therapy
• Renal replacement therapy
• Standing opioid requirements
• Neuropathic pain
• Fractures requiring emergency surgery
• End stage cardiac or respiratory disease
• Severe hepatic dysfunction,
• Patients with severe psychiatric disorders
• Vision loss
• Allergy to local anesthesia.
• Patients who refuse to consent to neuraxial anesthesia and/or peripheral nerve blocks will also be excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Opioid Counseling and PCS Video Group; This arm of the study will receive the opioid counseling and pain coping skills video 2 weeks prior to their surgery in addition to the conventional information provided to all patients undergoing total joint arthroplasty.	Other: Opioid Counseling and Pain Coping Skills Video; The intervention will be in the form of a video of a PowerPoint presentation with instructions and exercises designed to coach patients about catastrophizing, coping skills, mindfulness and behavioral modification techniques, in addition to providing education regarding postoperative analgesia and opioid use.
No Intervention: Standard of Care Group; This arm of the study will the conventional information provided to all patients undergoing total joint arthroplasty.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Post operative opioid consumption	Total opioid consumption during the first 72 hours following THA or TKA surgery, measured in oral morphine equivalents.	From surgery until 72 hours postoperatively.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Pain	Using the Visual Analog Scale (VAS) for Pain Assessment from 0 to 10 with 0 being no pain and 10 being extreme pain.	On postoperative days 1/2/3, and 1- and 6-week follow-up.
Length of hospital stay	Length of Stay from day of hospital admission to day of hospital discharge.	From day of admission until 72 hours postoperatively.
Time to first opioid demand dose	The number of hours from the time of surgery to the participants requesting their first opioid dose, either in the post-anesthesia care unit or the ward.	In the first 24 hours after surgery.
Post-operative complication rate	The incidence of postoperative complications, including events possibly related to opioid consumption.	24 hours after surgery, and 1/6 week follow-ups.
Total opioid consumption at 6-week follow-up	The total opioid consumption, reported at the 6 week follow-up.	6 weeks after surgery.
Need for rescue opioid breakthrough therapy	The need for rescue opioid breakthrough therapy in the first 24 hours after surgery, assessed as a binary (yes/no) outcome.	From surgery until 24 hours postoperatively.
Participant Compliance	Participant compliance, defined as whether or not participants in the experimental group viewed the study video.	Day of surgery
Participant satisfaction at baseline	Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire.	Baseline (up to 1 week before surgery).
Participant satisfaction at 1 week	Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire.	1 week after surgery.
Participant satisfaction at 6 weeks	Participants' satisfaction with the study video, assessed using a questionnaire. The questionnaire contains seven statements regarding the acceptability of the study video, with responses on a 5-point Likert scale from "highly agree" to "highly disagree." Only participants in the experimental group complete the satisfaction questionnaire.	6 weeks after surgery.

Collaborators and Investigators

• Sponsor: Sunnybrook Health Sciences Centre

Study record dates

Study Major Dates

• Study Start (Actual): September 20, 2022
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: January 7, 2022
• First Submitted That Met QC Criteria: January 7, 2022
• First Posted (Actual): January 21, 2022

Study Record Updates

• Last Update Posted (Actual): March 12, 2026
• Last Update Submitted That Met QC Criteria: March 10, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Treatment Adherence and Compliance; Health Behavior; Patient Acceptance of Health Care; Patient Participation; Physiological Effects of Drugs; Peripheral Nervous System Agents; Central Nervous System Depressants; Sensory System Agents; Analgesics; Narcotics; Analgesics, Opioid
• Other Study ID Numbers: 5218

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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