Effect of an educational intervention on prolonged oxycodone use after painful surgery

Abstract

Background Prolonged opioid use following surgery is common and may lead to opioid dependence, tolerance and addiction. Previous research demonstrated that patients often report a lack of knowledge about their pain therapy. Some educational interventions have been described to lead to safer and reduced opioid use.

Objective The purpose of this study was to measure the effect of an educational intervention on prolonged opioid use (2 and 4 weeks) following painful surgery. Secondly, satisfaction about the information provided was recorded and risk factors for prolonged oxycodone use were identified.

Methods All Dutch-speaking adult patients that underwent painful surgery (orthopedic surgery, neurosurgical spine surgery, traumatology surgery or bariatric surgery) in the St. Antonius Hospital were asked to participate. The educational intervention consisted of a patient information leaflet and a short educational session for trauma, anesthesiology and orthopedic residents. The first cohort of patients did not receive any education (control group), while the second cohort of patients received the information leaflet (intervention group). Surveys were sent to patients two (and four) weeks after surgery through email. The primary outcome was oxycodone use two and four weeks after surgery, the secondary outcome was patients’ satisfaction regarding oxycodone information provided. Binary logistic regression was used to determine predictors for prolonged oxycodone use.

Results The proportion of patients that used oxycodone did not differ 2 weeks (10.3% in control group, 15.1% in intervention group, p=0.187) and 4 weeks after surgery (3.3% in the control group and 6.8% in the intervention group, p=0.386). There was no significant difference in satisfaction about oxycodone information between the groups (p=0.098). A strong negative relation between patients’ satisfaction regarding the information provided and prolonged oxycodone use was found (p=0.000). Preoperative oxycodone use (p=0.000) and preoperative anxiolytic or antidepressant medication (p=0.009) were associated with prolonged oxycodone use.

Conclusion This simple educational intervention did not result in decreased oxycodone use 2 and 4 weeks after painful surgery or increased patient satisfaction.