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Journal of Pain & Palliative Care Pharmacotherapy Volume 27, 2013 - Issue 3
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Research Article

Characterization of Patients Undergoing Total Hip Arthroplasty in a Real-World Setting and Pain-Related Medication Prescriptions for Management of Postoperative Pain

Carmen S. KirknessCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.Correspondence[email protected]
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Carrie McAdam-MarxCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
,
Sudhir UnniCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
,
Jason YoungCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
,
Xiangyang YeCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
,
Arthi ChandranCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
,
Christopher L. PetersCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
&
Carl V. AscheCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedics, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.
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Pages 235-243 | Accepted 16 Jul 2012, Published online: 19 Nov 2012
 
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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.

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