Platelet-Rich Plasma and Pain Medication Reduction

Abstract

Problem: Pain is a major health problem that affects patients and families and proves challenging for providers to treat. Large portions of people suffer from pain that can be attributed to musculoskeletal injuries. Providers rely on current first-line recommendations for treating patients with these injuries. Unfortunately, the pain is not being adequately treated, the underlying injury is not being fixed, and many patients develop chronic pain. The solution has been a turn to chronic opioid prescribing that has now become an epidemic. Project Purpose: Autologous platelet-rich plasma (PRP) is a therapy with little to no risks and proven benefits in surgical procedures and treatment of a variety of injuries. Recently, PRP has been gaining prevalence in research and practice regarding treatment of musculoskeletal injuries. The results have been promising but more support is needed to show PRP can not only reduce pain but also help solve the issues surrounding medication use. By following the Plan-Do-Study-Act cycle, the proposed DNP project aimed to evaluate the effects of PRP on reducing medication consumption with patients being treated for musculoskeletal injuries at a Pain Management and Rehab clinic, specifically Kansas City Bone and Joint Clinic. Methods: The DNP project used a longitudinal observational quality improvement design that consisted of a convenience sample of patients diagnosed with acute and chronic musculoskeletal injuries who were being treated with PRP as part of their standard care, for musculoskeletal conditions such as knee osteoarthritis, lateral epicondylitis, hip and pelvic pathologies, jumper’s knee, and mild to moderate hamstring muscle tears. Candidates needed to be able to speak English, read at a high-school level, give consent, and track medication consumption for follow-up data collection. The primary outcome measure was to evaluate the type, quantity, and frequency of pain medication consumption. The VAS tool and Likert scale assessed pain and patient satisfaction as secondary outcome measures. An additional document was used to track the PRP injection process. Pre-injection data was collected, with follow-up evaluations occurring at week 2 and 4, and at month 2 post-injections. Descriptive statistics regarding each data point were analyzed to determine if the results either supported or refuted the assumptions of the DNP project. Conclusions: The data did not afford clear results regarding the primary outcome. However, secondary outcome measures indicated that PRP was at least partly successful in reducing pain and thus led to some degree of patient satisfaction. Despite limitations, the DNP project poses several implications for future research and practice.