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Background and Importance Surgical procedures such as total knee arthroplasty (TKA) and total hip arthroplasty (THA) are associated with risks of long-term opioid use. Implementing interventions that effectively reduce these risks remains a challenge.Aim and Objectives To assess the effect of a multifaceted intervention at patient-, nurse- and prescriber-level on postoperative prescribing and use of oxycodone after discharge in TKA and THA patients.Material and Methods A prospective monocentre pre-post intervention study was conducted. Patients ≥18 years scheduled for TKA or THA between 17/03/2025-04/04/2025 (pre-intervention) and 06/05/2025-23/05/2025 (post-intervention) were included. The multifaceted intervention combined (i) intensifying patient education on opiate use by pharmacy assistants, (ii) extending postoperative pain-assessment by nurses and (iii) tailoring oxycodone-prescribing by physicians. Primary outcomes were postoperative opioid prescribing and -use (percentage of patients discharged with an oxycodone prescription and percentage of patients using oxycodone on the day of discharge, and on day 1-3-7-14 post-discharge). Secondary outcomes were postoperative pain (Numeric Rating Scale pain scores) on the prespecified days, prescription/refill requests, and leftover medication after discharge. Differences between pre- and post-intervention groups were analysed using an unpaired t-test or Chi-squared test. Changes in pain scores over time and differences in these changes between groups were analysed using Mixed Repeated Measures ANOVA.Results Pre-intervention 34 patients were included, post-intervention 32 patients. Pre-intervention, 34/34 patients (100%) were discharged with oxycodone (immediate-release, IR), compared to 16/32 post-intervention patients (50%) (p<0.0001). This reduction remained significant for THA and TKA patients separately (p<0.0001 resp. p<0.005). No significant reduction in opioid use after discharge was observed among those patients discharged with oxycodone. Pain scores did not significantly differ between the pre- and post-intervention groups. Among patients who were not discharged with oxycodone IR, only one requested a prescription, which was ultimately not used. Pre-intervention, 28/34 (82.4%) patients had surplus oxycodone tablets, post-intervention less, but still 14/34 (41.2%), patients reported having oxycodone tablets left.Conclusion and Relevance The multifaceted intervention significantly reduced the proportion of THA and TKA patients postoperatively discharged with oxycodone IR without increasing postoperative pain after discharge. Nonetheless, post-intervention, 40% of patients had excess oxycodone tablets, indicating that there is room for further decrease of the availability of oxycodone and consequent risks of long-term use.Conflict of Interest No conflict of interest