- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05237531
Preoperative Education in Hand and Wrist Surgery
Preop Education and Opioid Use After Hand and Wrist Fracture ORIF: A Randomized Controlled Trial at a County Hospital
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Georgia
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Atlanta, Georgia, United States, 30303
- Grady Memorial Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Any patient over the age of 18 years with a closed carpal, metacarpal, or distal radius fracture undergoing outpatient surgical management at Grady Memorial Hospital, who is willing to participate and mentally capable to consent.
Exclusion Criteria:
- Patients who are inpatients at the time of surgery. Patients who have concomitant injuries on the same extremity as the carpal, metacarpal, or distal radius fracture. Patients with open fractures. Patients unable to tolerate non-steroidal anti-inflammatory drugs (NSAIDs). Non-English speaking patients will be excluded.
- Adults who are unable to consent will not be included.
- Individuals who are not yet adults will not be included.
- Pregnant women will not be included.
- Prisoners will not be included.
- Cognitively impaired individuals or individuals with impaired decision-making capacity will not be included.
- Individuals who speak English will be included. Individuals who have limited English proficiency but speak Spanish as a primary language will not be eligible for inclusion. Spanish-speaking patients will be excluded because the components of the educational protocol (video, questionnaires, surveys) are not available in Spanish.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental Arm
Patients in the experimental arm will receive standardized preoperative education in the form of a brief video, interactive quiz, and written handout. All patients will receive standardized multimodal pain management consisting of a long-acting peripheral nerve block, scheduled non-opioid pain medications, an opioid prescription to be taken only as needed, and adjunctive medicines to be taken as needed for any side effects. |
The standardized preoperative education includes a brief video, an interactive quiz, and a written handout. The video will provide information on the proper use and common side effects of opioid pain medications, the expected effects of a peripheral nerve block, and the concept of multimodal postoperative pain management with non-opioid medications and non-pharmaceutical pain management strategies. The interactive quiz will reinforce the critical components of the video in a question-and-answer format which requires active participation. The written handout will summarize the educational content in a form which can be easily referenced by patients at home.
Preoperative questionnaire: Demographic questions plus specific questions about chronic pain, prior opioid use, and mental health diagnoses Postoperative questionnaire: Questions about pain control after surgery, satisfaction with pain control, healthcare contact since surgery, opioid consumption since surgery, and satisfaction with education
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Active Comparator: Control Arm
Patients in the control arm will receive education per the provider's preference (current standard of care). All patients will receive standardized multimodal pain management consisting of a long-acting peripheral nerve block, scheduled non-opioid pain medications, an opioid prescription to be taken only as needed, and adjunctive medicines to be taken as needed for any side effects. |
Preoperative questionnaire: Demographic questions plus specific questions about chronic pain, prior opioid use, and mental health diagnoses Postoperative questionnaire: Questions about pain control after surgery, satisfaction with pain control, healthcare contact since surgery, opioid consumption since surgery, and satisfaction with education
Education per provider preference (no standardization, current standard of care)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in total oral morphine equivalents consumed from day of surgery to postoperative day 10
Time Frame: Day of surgery, postoperative day 10
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Change in oral morphine equivalents consumed from day of surgery to postoperative day 10 (POD 10).
The total amount of morphine equivalents consumed between the 2 study arms will be compared.
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Day of surgery, postoperative day 10
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total opioid consumption during the postoperative course
Time Frame: Up to postoperative day 10
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Total opioid consumption in mg during the postoperative course taken from the pain diary and postoperative questionnaire.
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Up to postoperative day 10
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Total number of opioid refills in the postoperative period
Time Frame: Up to postoperative day 10
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Number of opioid refills in the postoperative period based on postoperative questionnaire and prescription drug monitoring program (PDMP) database.
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Up to postoperative day 10
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Change in average daily VAS pain scores for early (postoperative day 0-3), middle (postoperative day 4-7), and late (postoperative day 8-10) postoperative period between the two study arms
Time Frame: Baseline, postoperative day 0-3, postoperative day 4-7, postoperative day 8-10
|
Average visual analog scale (VAS) pain score will be collected for early (postoperative day 0-3), middle (postoperative day 4-7), and late (postoperative day 8-10) postoperative period from the pain diary, and results will be compared between both study arms.
Total score ranges between 1-10 and 10 correlates with worse pain.
|
Baseline, postoperative day 0-3, postoperative day 4-7, postoperative day 8-10
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Total number of unscheduled healthcare contact (UHC) up to 30 days after surgery
Time Frame: Up to 30 days after surgery
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UHC includes telephone calls to clinical staff (documented in electronic medical record), early clinic visits, emergency room visits, and readmissions to the hospital
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Up to 30 days after surgery
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Type of reason of unscheduled healthcare contact (UHC) up to 30 days after surgery
Time Frame: Up to 30 days after surgery
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UHC includes telephone calls to clinical staff (documented in electronic medical record), early clinic visits, emergency room visits, and readmissions to the hospital.
The reason will be collected from the day of surgery until 30 days after surgery.
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Up to 30 days after surgery
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Change in results of Pain Management quiz after education
Time Frame: Preoperative, day of surgery
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Change in results of Pain Management Quiz before and after education.
Answers to the questions on the quiz are either correct or incorrect.
Total number questions are 11.
It will be measured as total number of correct answers/total number of questions (number of correct/11).
This will be converted to a percentage correct.
Range of score will be 0% - 100% correct.
Higher change in percentage correct is a better outcome.
Change in percentage correct from preoperative appointment to day of surgery will help determine the effectiveness of the educational protocol.
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Preoperative, day of surgery
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Postoperative Satisfaction score with education
Time Frame: Postoperative (up to 2 weeks after surgery)
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Based on the postoperative questionnaire, participants will answer a question about satisfaction with 5 possible answers: Very satisfied, Somewhat satisfied, Neutral, Somewhat dissatisfied and Very dissatisfied. Results will be in percentage, based on number of participants in each category. "Very satisfied" correlates with better outcome with lower level of satisfaction until "very dissatisfied" that correlates with worse outcome. |
Postoperative (up to 2 weeks after surgery)
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Percentage of participants with adequate postoperative pain control
Time Frame: Postoperative (Up to 2 weeks after surgery)
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Based on the postoperative questionnaire, participants will answer a question about pain control: "Do you feel like your pain was adequately controlled after surgery?" Possible answers include:Yes, No and Somewhat. Number of participants who answer "Yes" will be counted per randomization group. A higher result correlates with better outcome (better pain control). |
Postoperative (Up to 2 weeks after surgery)
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Paul Ghareeb, MD, Emory University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY00003074
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
- Anyone who wishes to access the data
- Any purpose
- Data will be available indefinitely
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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