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Does Patient Education Prior to Arthroscopic Rotator Cuff Repair Decrease Narcotic Consumption? A Randomized Prospective Study

      Introduction

      We sought to determine, through a randomized prospective study design, if patient education on proper use of narcotic medication would decrease narcotic consumption in the post-operative period after arthroscopic rotator cuff repair (ARCR).

      Methods

      Patients undergoing primary ARCR were prospectively enrolled in a randomized fashion, to receive either formal education on proper use of narcotics versus no education. The education group received instruction on the proper use of opioids, dosage, side effects, dependence, and addiction while the control group received education regarding the surgery. To determine risk of opioid abuse of the patient, the physician completed a validated Opioid Risk Tool (ORT). Patients filled out questionnaires at their 2- and 6- week follow up querying VAS pain score, refills, and total number of narcotic pills remaining. Standard statistical comparison was performed with t test calculations.

      Results

      67 patients completed 6-week follow-up and there were no statistically significant differences in age, sex, BMI, ORT score, preoperative and postoperatively VAS score between the study and control groups. Patients who received pre-operative education on average consumed 26 pills compared to 35 in the control group. More than 20 pills were consumed by only 48% of the study group compared to 76% in the control group (p = 0.01).

      Conclusion

      Patient education is associated with a significant decrease in the number of patients consuming more than 20 narcotic pills in the acute post-operative period. The increased frequency of patients in the control group that consumed a high number of narcotics suggests preoperative education was beneficial. This is the first study to document that preoperative education can help reduce the number of patients consuming high levels of post-operative narcotics. Future recruitment and study analysis will help determine if this effect is long-lasting and can help reduce the incidence of drug dependence and addiction among this patient population.