Decreasing Unused Opioids in the Home Post Supracondylar Fracture Repair

Completed

• Conditions: Pain Management

• Registration Number: NCT04059055
• Lead Sponsor: The Hospital for Sick Children

Brief Summary

Over the past two decades, the misuse of prescription opioids has significantly increased. A recent systematic review reported as much as 67% to 92% of opioids dispensed on discharge post-surgery go unused. This culture of overprescribing is consistently observed across surgical specialties. Less frequently observed is the potential for opioid use and misuse in children and adolescents post-surgery. The research to date in this area has been poorly performed with heterogenous data collection, analysis and reporting, as well as large loss of patients to follow-up.

The investigators' previous prospective observational deception study identified three areas of concern:

1. There is a culture of postoperative opioid over-prescribing at discharge as demonstrated by heterogenous opioid dosing and duration of treatments across practitioners for single procedures

2. This overprescribing is in excess of patients' home-requirements and results in significant quantities of leftover opioids

3. There is a culture of inappropriate storage and lack of safe disposal of prescribed opioids in the community

Detailed Description

This study focuses on addressing and minimizing pediatric surgical over-prescribing. It aims to reduce the amount of opioids prescribed by focusing prescribers and families on regular use of simple non-opioid analgesics, as well as decreasing the amount of opioids prescribed and dispensed.

Study Timeline

• Study First Submitted: 2019-08-14
• Study First Submitted QC: 2019-08-14
• Study First Posted: 2019-08-16
• Study Start: 2019-10-01
• Primary Completion: 2020-09-30
• Study Completion: 2020-09-30
• Status Verified: 2021-12
• Last Update Submitted: 2021-12-16
• Last Update Posted: 2021-12-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 175

Inclusion Criteria

• Patients with supracondylar fractures undergoing surgical wire placement or pinning that return to fracture clinic at three weeks for removal of pins/wires.
• Patients discharged on the weekday.
• Families filling a prescription for opioids at Shoppers Drug Mart at SickKids Hospital.
• Parent has strong command of the English language (i.e., no interpreter required).

Exclusion Criteria

• Patients with a history of chronic pain.
• Patient used opioid medication within the previous 6 months.
• Patients who are discharged on the weekend (as participant emails will need to be entered into redcap the day of recruitment, for data collection to commence the next morning).

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Pain medication use questionnaire	3 days following discharge from hospital	Recording of how many pain meds were used at home

Secondary Outcome Measures

Name	Time	Method
Amount of opioid returned	3 weeks following discharge (aligns with pin/wire removal at fracture clinic)	Recording of how much opioid was returned to the hospital

Trial Locations

Locations (1)

The Hospital for Sick Children; 🇨🇦 Toronto, Ontario, Canada