• Samantha Bremner, Fiona Webster, Joel Katz, Judy Watt-Watson, and Colin McCartney.
• Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
• J Opioid Manag. 2012 May 1;8(3):145-52.

ObjectiveMost total knee arthroplasty (TKA) recipients experience pain following the procedure. Patients are provided with medications to manage pain but there is little information regarding their usage of analgesics after hospital discharge. This study investigated analgesic usage in recent TKA recipients.Design And ParticipantsA qualitative descriptive approach was taken to produce a summary of the experiences of 14 participants. Purposive sampling methods were used during recruitment. One semistructured interview was conducted with each participant. Interviewing continued until theoretical saturation was reached.ResultsMost participants used less medication than was prescribed and stopped taking prescription analgesics before requiring a renewal. Participants adjusted their usage in response to pain, adverse effects, advice from their family and healthcare providers, fears of becoming "hooked," and a general dislike of taking medications.ConclusionsPatient modifications to medication regimens are often labeled as patient nonadherence; however, participants in this study considered their actions to be adaptive. This conceptual distinction has practical implications for healthcare providers. These findings emphasize the importance of having TKA patients develop their pain management regimen in conjunction with healthcare providers so that regimens can be tailored to individual needs.

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