Musculoskeletal disease: Total knee replacement Musculoskeletal Diseases
Conditions
Interventions
Patients self-medicate their oral analgesics post total knee replacement when sufficently recovered from the anaesthetic. Treatment as usual comparator cohort have analgesics dispensed as per usual by
Sponsors
Norfolk and Norwich University Hospital NHS Trust (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. All adult patients (e.g. aged over 18) undergoing a primary total knee replacement operation 2. Must meet the Norfolk and Norwich University Hospital NHS Foundation Trust self-management of pain criteria 3. Are expected to require standard step 1-3 oral analgesics post-operatively (WHO 2009) 4. Post-operatively, patients must be awake and breathing independently, able to answer questions and follow commands to continue in the protocol 5. Are English speaking and literate (we expect patient participants to be able to read the information sheet and fill in a number of self-assessments) 6. Patients may have received regional blocks or epidural analgesia, and will start PaDSMaP or TAU as soon as they begin oral analgesia
Exclusion criteria
Exclusion criteria: 1. Expected to require intensive care 2. Known or suspected to be opioid tolerant or dependent 3. Regular users of any modified release opiate preparation for > two weeks prior to total knee replacement 4. Recent history of drug or alcohol abuse 5. Patients who lack competence to consent by reason or dementia or any other reason 6. Any patient who does not self-administer at home
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain levels for patients at three days post-operatively or at discharge (whichever is the sooner) as measure on a non-graded 10cm visual analogue scale (VAS) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Pain during inpatient stay and after six weeks post-operatively (non graded 10cm VAS) 2. Satisfaction with pain levels patient questionnaire 3. Satisfaction with Information About Medicines Scale (SIMS) 4. EuroQOL EQ-5D questionnaire (EQ-5D) 5. Oxford Knee Score (OKS) 6. Time to mobilisation after operation (e.g. day on which patient was able to stand up and transfer from bed to chair) 7. Medication usage (Inpatient Prescription Chart and CRF) 8. Adverse events (CRF) 9. A health resources questionnaire 10. Qualitative evaluation of patient's and health professionals' experiences | — |
Countries
United Kingdom
Outcome results
None listed