Effect of a digital intervention on pain and reliance on opioids after total knee replacement surgery

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The efficacy and safety of digitally delivered pain self-management interventions for reducing pain after surgeries, including total knee replacement (TKR), have been demonstrated in several randomised controlled trials. However, little is known about the feasibility and effectiveness of these interventions in Australian hospital settings. The current project evaluates the implementation and effectiveness of an mHealth intervention designed to support patients’ engagement with pain self-management after TKR surgery. Consenting patients (N = 130) who are scheduled to undergo TKR surgery will be randomised to receive either a psychoeducational video prior to surgery, and one SMS text message per day for 3 weeks after surgery, or the pre-surgery psychoeducational video only. Both groups will continue to receive usual care. Outcome measures including pain intensity (primary), opioid dose, pain-related distress, and perceived social isolation will be recorded at baseline, 3 days, 3 weeks, 6 weeks, 3 months, and 6 months after surgery using self-reported surveys. Pain self-efficacy will be measured at 6 week, 3 months and 6 months post-surgery. Implementation outcomes will be evaluated using mixed (quantitative-qualitative) methods. This trial represents a first step towards the translation of digitally delivered non-pharmacological acute pain management in the Australian healthcare system.