Our mission is to empower patients to understand and manage their pain with confidence.
KNOWLEDGE. SUPPORT. CONFIDENCE.
Scale of the problem
COVID-19.
Total Knee and Hip Arthroplasty surgeries were among the first elective surgeries that were put on pause as health care systems globally grappled with the pandemic and the increased healthcare burden it caused.
Waitlists grew.
In Canada, approximately 48,000 surgeries were not performed in the past 2 years based on average volume increases expected before the pandemic as per the Canadian Joint Registry Report 2022.
In the US, the exact number of delayed or canceled arthroplasty cases is unknown but between 77,000 and 372,000 required rescheduling.
Healthcare systems adapted.
To reduce waitlist numbers, surgeons began performing more joint replacements as day surgeries, discharging patients home directly from the recovery room.
In Canada, there was a 388% increase in day surgeries in 2021 vs 2020.
In the US, it is projected that 51% of joint replacements will be performed as day surgeries in 2026.
Patients adapted.
Instead of staying in hospital after surgery and having medications managed by a nursing/pharmacy team, patients were now expected to deal with their immediate post-operative pain control and medications at home with no direct support.
Pain Coach was born.
In an effort to provide support with post-op pain/medication use for these Day Surgery patients, Pain Coach got to work. Our tools are meant to support patients so that more can receive the Day Surgery model and reduce system burden.
Some numbers.
The global orthopedic joint replacement market in 2019 was $20 billion (USD) and is projected to reach $26.9 billion (USD) by 2027.
Approximately 6% of surgical patients who do not use opioids before surgery become persistent opioid users after receiving a prescription at surgical discharge.
References:
1. AJRR Annual Report Preview; American Academy of Orthopedic Surgeons. https://www.aaos.org/globalassets/registries/ajrr-2021-annual-report-preview.pdf Accessed Oct 12, 2022.
2. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths—United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2016;64(50-51):1378-1382. doi:10.15585/mmwr.mm6450a32021
3. Florence CS, Zhou C, Luo F, Xu L. The economic burden of prescription opioid overdose, abuse, and dependence in the United States, 2013. Med Care. 2016;54(10):901-906. doi:10.1097/MLR.0000000000000625
4. CJRR annual report: Hip and knee replacements in Canada;CIHI https://www.cihi.ca/en/cjrr-annual-report-hip-and-knee-replacements-in-canada Accessed Oct 12 2022.
5. Karhade AV, Schwab JH, Bedair HS, MD. Development of Machine Learning Algorithms for Prediction of Sustained Postoperative Opioid Prescriptions After Total Hip Arthroplasty. The Journal of Arthroplasty 34 2019; 2272e2277. Doi: 10.1016/j.arth.2019.06.013.
6. Brummett CM, Englesbe M et al.. Predicting postoperative opioid use with machine learning and insurance claims in opioid-naïve patients. The American Journal of Surgery. 222 (2021) 659e665. Doi: 10.1016/j.amjsurg.2021.03.058
7. VanIderstein C, Dunbar M, Johnston E. Opioid Prescribing Habits of Orthopedic Surgeons Following Total Hip Arthroplasty and Total Knee Arthroplasty: A Pilot Study. Can J Hosp Pharm. 2022;75(4):335-9. https://doi.org/10.4212/cjhp.3282
8. VanIderstine C, Johnston E. Risk Factors for Prolonged Opioid Use Following Total Hip Arthroplasty and Total Knee Arthroplasty: A Narrative Review of Recent Literature. Annals of Pharmacotherapy. 2023;57(7):837-846. doi:10.1177/106002802211330781.
9. Robinson MG, Greene N, Katakam A, Chen A, Bedair HS, Humphrey T, Melnic CM. The effect of the COVID-19 pandemic on revision total hip and knee arthroplasty at a large academic hospital network. J Orthop. 2021 Nov-Dec;28:117-120. doi: 10.1016/j.jor.2021.11.012. Epub 2021 Nov 24. PMID: 34840481; PMCID: PMC8610569.
10. OrthoInfo from the American Academy of Orthopedic Surgeons. Outpatient Total Joint Replacement (aaos.org) Accessed July 25, 2023.