Educational Video for Patient Empowerment

Overseen By Ahtsham U Niazi, FRCPC

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Sunnybrook Health Sciences Centre

Must not be taking: Opioids

Disqualifiers: Chronic pain, Severe psychiatric disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

220 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are on long-term opioid therapy or have standing opioid requirements, you may not be eligible to participate.

What data supports the effectiveness of the treatment Opioid Counseling and Pain Coping Skills Video, Preoperative Opioid Counseling, Pain Coping Skills Video, Preoperative Pain Education?

Research shows that video-based opioid education can increase patients' knowledge about opioids, and preoperative pain education can improve pain management outcomes. Additionally, preemptive pain psychoeducation can reduce anxiety and postoperative pain, leading to fewer opioid prescriptions and potentially lowering the risk of chronic pain. ^{1 2 3 4 5}

Is the Educational Video for Patient Empowerment safe for humans?

The research suggests that educational videos about pain management and opioid safety are generally safe for humans. These videos aim to improve knowledge and reduce anxiety, which can help decrease the need for opioid prescriptions and potentially lower the risk of developing chronic pain after surgery. ^{2 4 6 7 8}

How does the educational video treatment differ from other treatments for postoperative pain management?

The educational video treatment is unique because it focuses on empowering patients with knowledge about pain management and opioid use, aiming to reduce opioid prescriptions and improve patient outcomes by addressing psychological needs and expectations before and after surgery. Unlike traditional treatments that rely heavily on medications, this approach uses preemptive and preventive psychoeducation as part of a multimodal pain management strategy. ^{2 4 9 10 11}

What is the purpose of this trial?

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.

Eligibility Criteria

Adults over 18 scheduled for knee or hip replacement surgery can join this trial. They must understand English, have internet access, and score at least 18 on a cognitive test. People with severe liver issues, allergies to local anesthesia, chronic pain conditions, opioid use before the study, certain psychiatric disorders or vision loss cannot participate.

Inclusion Criteria

I am healthy or have mild to severe systemic disease and am scheduled for elective surgery.

I scored at least 18 on the MoCA test, showing I can understand instructions for pain management.

I am receiving treatment for a psychological condition.

Exclusion Criteria

I am on dialysis.

I have severe liver problems.

I refuse to consent to spinal or nerve block anesthesia.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-operative Education

Participants receive a 30-minute online educational video on opioid and non-opioid medication use and pain coping skills 2 weeks prior to surgery

2 weeks

1 virtual session

Immediate Post-operative Monitoring

Participants are monitored for opioid consumption and pain levels using the Verbal Analog Scale (VAS) for 72 hours post-surgery

72 hours

Follow-up

Participants are monitored for opioid consumption and return unused opioids at 6 weeks post-surgery

6 weeks

1 in-person visit

Treatment Details

Interventions

• Opioid Counseling and Pain Coping Skills Video

Trial Overview The trial is testing if watching a pre-operative educational video about using opioids safely and other pain management techniques can reduce opioid consumption after surgery. The video includes instructions on medication use and exercises to cope with pain.

Participant Groups

Group I: Opioid Counseling and PCS Video Group Experimental Treatment 1 Intervention

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.

Group II: Standard of Care Group Active Control 1 Intervention

This arm of the study will the conventional information provided to all patients undergoing total joint arthroplasty.

Who Is Running the Clinical Trial?

Sunnybrook Health Sciences Centre

Lead Sponsor

Trials

693

Recruited

1,569,000+

Findings from Research

A standardized perioperative education model based on the ACS SEPCAS brochure significantly improved patients' understanding of opioid use, including safe storage and disposal, as well as recognizing overdose signs, with 66 patients surveyed before and after the intervention.

Patients who received the SEPCAS brochure found it useful for their recovery and recommended it for all surgical patients, indicating its effectiveness as an educational tool in reducing opioid-related risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention. Fender, Z., Bleicher, J., Johnson, JE., et al.[2023]

A study involving 110 patients showed that a 5-minute video-based opioid education tool significantly increased patients' self-rated knowledge about opioids compared to traditional education methods, with a notable difference in ratings (p=0.013).

While not statistically significant, there were trends indicating that patients who received the video intervention had lower rates of opioid use at 30 days (76% vs 88.7%) and at 90-150 days (10% vs 22.6%) compared to those who received standard education, suggesting potential benefits in reducing opioid prescriptions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Video-Based, Patient-Focused Opioid Education in the Perioperative Period Increases Self-Perceived Opioid-Related Knowledge: A Pilot Study. Goree, JH., Srinivasan, N., Cucciare, MA., et al.[2022]

A 12-month study involving 99 patients showed that preoperative pain management education significantly improved patients' understanding of medication side effects and encouraged the use of nonpharmacologic methods for pain relief, leading to better pain management outcomes.

Patients who received targeted education reported more frequently on the effects of pain on their mood and their use of nonpharmacologic methods, suggesting that tailored preoperative education can enhance postoperative pain management knowledge and potentially prevent negative outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preoperative Pain Management Education: An Evidence-Based Practice Project. O'Donnell, KF.[2019]

Preoperative psychoeducation can significantly reduce patients' anxiety and improve their expectations about surgical outcomes, which may lead to decreased postoperative pain and faster recovery times.

By integrating psychological support into pain management strategies, such as preemptive psychoeducation, there is potential to reduce reliance on opioids, thereby lowering the risk of developing chronic postsurgical pain and addressing the opioid epidemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preemptive and Preventive Pain Psychoeducation and Its Potential Application as a Multimodal Perioperative Pain Control Option: A Systematic Review. Horn, A., Kaneshiro, K., Tsui, BCH.[2020]

A structured preoperative education program for patient-controlled analgesia (PCA) did not significantly impact overall pain management outcomes or morphine consumption in 60 women undergoing major gynecologic surgery.

While patient satisfaction was higher in the education group during early recovery, this benefit did not persist throughout the postoperative period, indicating that ongoing education and support from pain specialists may be more influential in long-term satisfaction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Structured preoperative patient education for patient-controlled analgesia. Lam, KK., Chan, MT., Chen, PP., et al.[2019]

A pilot study involving 152 military health system beneficiaries demonstrated that an app-based pain education program was feasible and well-received, with 73% of participants finding the videos helpful.

The study suggests that providing tablet-based pain management education in various clinic settings, not just specialty pain clinics, can enhance patient understanding and discussions about pain management and opioid safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

App-Based Pain Management and Opioid Education Program for Patients in Clinic Waiting Rooms. Highland, KB., Giordano, NA., Kirk, K., et al.[2021]

Prescription opioids are responsible for 40% of opioid overdose deaths in the U.S., highlighting the critical role healthcare professionals, especially pharmacists, play in educating patients about the risks of opioid use.

There is a lack of empirical research on how pharmacists communicate opioid risks to patients, including what topics are discussed or omitted, and what barriers exist to effective communication, indicating a need for improved counseling practices and further research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Communication between patients and health care professionals about opioid medications. Thakur, T., Frey, M., Chewning, B.[2022]

A study analyzing 1309 questions from healthcare providers during opioid prescribing training revealed that while most concerns aligned with the FDA Blueprint, there were significant gaps in addressing topics like safe alternatives to opioids and government regulations.

Providers expressed a strong need for guidance on effective communication with patients and understanding the role of marijuana in opioid therapy, indicating that future educational resources should expand to cover these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What do providers want to know about opioid prescribing? A qualitative analysis of their questions. Cushman, PA., Liebschutz, JM., Hodgkin, JG., et al.[2022]

The implementation of a preoperative instructional DVD significantly increased patients' knowledge and preparedness for surgery, covering essential topics like pain management and postoperative care activities.

Nurses observed improved patient and family engagement and understanding regarding postoperative care, suggesting that the DVD effectively enhanced communication and education before surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a preoperative instructional digital video disc on patient knowledge and preparedness for engaging in postoperative care activities. Ong, J., Miller, PS., Appleby, R., et al.[2019]

The patient education video aimed at encouraging assertiveness in seeking pain relief did not lead to significant differences in pain levels or requests for analgesia among the 60 preoperative patients studied.

Despite experiencing considerable pain after surgery, patients across all groups were generally satisfied and did not actively seek to eliminate all their pain, suggesting that patient attitudes towards pain management may play a crucial role.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of an education video on patients' requests for postoperative pain relief. Hawkins, R., Price, K.[2007]

A quality improvement initiative that included shared decision-making and preoperative education led to a significant reduction in opioid prescriptions, decreasing the average number of oxycodone pills prescribed from 12.29 to 6.80 per surgery (p < 0.001).

The initiative also resulted in a decrease in unused pills from 70.5% to 48.5% (p < 0.001), and increased patient satisfaction with their surgical experience, highlighting the effectiveness of personalized pain management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shared decision-making for postoperative opioid prescribing and preoperative pain management education decreases excess opioid burden. Ciampa, ML., Liang, J., O'Hara, TA., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention. [2023]

2. New Zealand pubmed.ncbi.nlm.nih.gov

Video-Based, Patient-Focused Opioid Education in the Perioperative Period Increases Self-Perceived Opioid-Related Knowledge: A Pilot Study. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Preoperative Pain Management Education: An Evidence-Based Practice Project. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Preemptive and Preventive Pain Psychoeducation and Its Potential Application as a Multimodal Perioperative Pain Control Option: A Systematic Review. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Structured preoperative patient education for patient-controlled analgesia. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

App-Based Pain Management and Opioid Education Program for Patients in Clinic Waiting Rooms. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Communication between patients and health care professionals about opioid medications. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

What do providers want to know about opioid prescribing? A qualitative analysis of their questions. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Effect of a preoperative instructional digital video disc on patient knowledge and preparedness for engaging in postoperative care activities. [2019]

10. Australia pubmed.ncbi.nlm.nih.gov

The effects of an education video on patients' requests for postoperative pain relief. [2007]

11. Germany pubmed.ncbi.nlm.nih.gov

Shared decision-making for postoperative opioid prescribing and preoperative pain management education decreases excess opioid burden. [2023]