Rob Keller, MD, and Nicholas Frisch, MD, are testing a proactive medication protocol, ClickOn Detroit reports. The approach may benefit physicians in the outpatient setting, who have less control over the medication patients take or how they're using it after discharge.
Here are six insights.
1. The proactive protocol is part of a pilot study at Rochester, Mich.-based Ascension Crittenton Hospital. About 30 to 40 patients undergoing anterior cruciate ligament reconstructions, rotator cuff repairs or total shoulder procedures have been involved in the study so far.
2. Dr. Keller and Dr. Frisch administer nonopioid medications on a schedule that prevents the pain from intensifying to the point where strong opioids are necessary. They use the proactive approach on all their patients.
3. Patients begin taking some medicine one to two weeks before surgery.
The orthopedic surgeons select medications that target different pathways of pain.
"There's Tylenol, everyone knows that, there's an anti-inflammatory; there's Tramadol which is a small pain medicine and then there's Gabapentin, which is a nerve medication," Dr. Keller told ClickOn Detroit.
4. The average opioid intake using the protocol is about a half a pill, compared to as many as 50 pills normally required for the procedures being studied.
5. The physicians have received few calls to refill pain medication, a change from previous medication protocols.
6. The physicians would like to expand the study to multiple centers.