(PS2-24) Use of Motivational Interviewing to Improve Pain Outcomes in Arthroplasty Patients

Abstract Text: Behavioral interventions have been used to improve psychosocial factors, including sleep, anxiety, depression, and overall function in adults with persistent pain. Prior research has found that motivational interviewing (MI) could be used reduce pain as well as opioid use among chronic pain groups as well individuals who have experienced a physical injury. The aim of present study was to examine whether MI reduced pain intensity and severity in individuals had undergone elective joint replacement surgery. To improve post-surgery pain outcomes, patients receiving total and partial joint arthroplasty surgeries were randomized at a 1:1 ratio and received either 1) MI intervention or 2) Enhanced usual care (EUC) following their procedure. Licensed clinicians conducted seven 20 minute intervention sessions via phone call with participants over the course of seven weeks starting at two weeks post-op. Participants completed weekly and monthly online assessments, which included mood, pain, sleep, and anxiety questionnaires, up to 12 months after their surgery. All statistical analyses were run using SAS 9.4 TS1M8 (9.4 M8). Pain Severity and Interference scores were assessed as separate outcomes by a Linear Mixed Model with a subject-specific random intercept and repeated measures. Fixed effects included months post-surgery and randomization group. In crude models, randomization group was not significantly associated with pain severity (p = 0.0653) or pain Interference (p=0.0592). However, the interaction between pain interference and months post-surgery was significant (p=0.0356), suggesting the effect of intervention varies over time. Models were adjusted for known covariates sleep disturbance, depression, physical functioning, sex, race, and surgery type. In adjusted models, randomization was also not significantly associated with pain severity (p = 0.1111) or pain interference (p=0.3083), although physical functioning, sleep disturbance, race, and surgery type demonstrated significance in both models. The results of this study suggest that there was no difference in pain intensity or severity between the MI and EUC groups. Limitations of the study include the focus on a specific population undergoing total and partial joint arthroplasty. Future research should therefore examine the time-dependent effects of MI on pain interference across a broader range of surgical procedures with longer follow-up periods. Other directions for future research include examine and compare the effectiveness of other behavioral interventions on pain outcomes in post-surgery patients.