title: Characterization of patients undergoing total hip arthroplasty in a real-world setting and pain-related medication prescriptions for management of postoperative pain.
abstract: This observational study characterized medication use in the immediate postoperative period among patients undergoing total hip arthroplasty (THA) at an academic medical center, and evaluated pain (0-10 numerical pain rating scale [NPRS]; 0 = no pain, 10 = worst pain that the patient can imagine), function (Harris Hip Score [HSS]and Lower Extremity Function Scale [LEFS]), and health-related quality of life (SF-36). Study patients (N = 115; 59% female; average age 61.3 ± 12.0 years; mean BMI of 29.9 ± 6.9 kg/m2) who underwent THA between September 1, 2008, and November 30, 2010, and met study inclusion criteria were drawn from the University of Utah Orthopedic Clinic database. The most common comorbidities in these patients were osteoarthritis, hypertension, and chronic back pain. The most frequently prescribed class of pain-related medications in the immediate postoperative period was opioids. The most common nonopioid medications were bupivacaine, celecoxib, and midazolam. Opioids and celecoxib continued to be commonly prescribed at discharge. Pain was improved at a 6-week follow-up (mean change −3.3 ± 3.3 points), as were HSS and LEFS, with mean changes of 19.9 ± 24.2 and 8.7 ± 16.9 points (P < .01 for both), respectively. Although SF-36 scores were also improved, these scores were significantly lower relative to normative values for the US general population as well as relative to individuals having both osteoarthritis and hypertension.
authors.affiliation: Center for Outcomes Research, University of Illinois College of Medicine, Peoria, Illinois 61656, USA. csk@uicomp.uic.edu
authors.forename: Carmen S
authors.initials: CS
authors.lastname: Kirkness
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Sudhir
authors.initials: S
authors.lastname: Unni
authors.forename: Jason
authors.initials: J
authors.lastname: Young
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Ye
authors.forename: Arthi
authors.initials: A
authors.lastname: Chandran
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Peters
authors.forename: Carl V
authors.initials: CV
authors.lastname: Asche
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid