Patient Perceptions Regarding Opioid Use: Factors Influencing Participation in a Postoperative Pain Management Randomized Controlled Trial after Carpometacarpal Arthroplasty.

Abstract

The opioid epidemic has motivated hand surgeons to explore alternatives to postoperative pain management. We retrospectively analyzed patients who declined participation in our double-blind randomized controlled trial (RCT) comparing ibuprofen/acetaminophen to oxycodone after carpometacarpal arthroplasty. The purpose of this study was to analyze patient considerations for declining participation to elucidate perspectives on postoperative pain control.We conducted a retrospective cohort study of eligible preoperative patients approached for our RCT between February 2021 and July 2024. Rationale for declining was recorded, and demographic and clinical characteristics were extracted. Associations between baseline demographic and clinical characteristics and reasons for declining were examined.Out of 102 eligible patients approached, 62 (60.8%) enrolled while 40 (39.2%) declined. Of patients who declined, 20 participants (50.0%) cited opioid side effects or other opioid concerns. Eight patients (20.0%) were not interested in participating in research, and 6 patients (15.0%) wanted to ensure opioid access for effective pain control. Patients also cited side effects of ibuprofen/acetaminophen (2, 5.0%) or other medical concerns (4, 10.0%) when declining. Surgery on the right hand was the only significant association with the decision to enroll (P < .05), while surgery on the dominant hand was not significantly associated (P = .15).Our study identifies a trend in patient beliefs about postoperative pain control following hand surgery with half of the declined cohort referencing opioid-related concerns. Hand surgeons should consider patient perspectives when developing future postoperative pain studies and implementing protocols.

View details for DOI 10.1177/15589447261437834

View details for PubMedID 42077115