Association of Occupational and Physical Therapy With Duration of Prescription Opioid Use After Hip or Knee Arthroplasty: A Retrospective Cohort Study of Medicare Enrollees.

This was an observational claims study, so it shows an association, not that OT/PT caused shorter opioid use. Pain severity, opioid dosage, and adherence to therapy were not measured, and patients may have been selected for home health or interventions because of unrecorded clinical needs. The intervention group was not a single therapy: it included OT/PT evaluations plus exercise, physical agent modalities, manual therapy, and rare acupuncture or psychological interventions, so the effect of any one component cannot be separated. Home health was part of the positive association, and the data could not confirm whether outpatient non-drug interventions were delivered by therapists or other billers. 10.25% of patients were censored, often because of hospitalization, which could affect the timing of opioid discontinuation. Results apply only to Medicare beneficiaries aged 66 or older discharged home after elective hip or knee replacement, not to younger patients, managed care members, or patients discharged to skilled nursing or inpatient rehab.

No conflicts of interest were reported by the authors. The article metadata lists NIH and U.S. government funding support.

Do not read this as proof that OT/PT alone shortens opioid use. The association appeared only when patients also received home health, and the study did not separate OT/PT from other non-drug interventions or home health services.