Characterizing Patients after Opioid Taper in a VA Medical Center. (3rd April 2021)

• Record Type: Journal Article
• Authors: Muzzio, Kathryn; Chandler, Michael; Painter, Jacob T.; Dragic, Lisa
• Is Part Of: Journal of pain & palliative care pharmacotherapy. Volume 35:Number 2(2021)
• Page Start: 84
• Page End: 90
• Publication Date: 2021-04-03
• Subjects: Chronic pain -- pharmacists -- opioid -- pain management -- opioid taper -- Veterans affairs; Pain -- Treatment -- Periodicals; Analgesia -- Periodicals; Palliative treatment -- Periodicals; Analgesics -- Therapeutic use -- Periodicals; Pain -- drug therapy -- Periodicals; Pain -- prevention & control -- Periodicals; Palliative Care -- Periodicals; Analgesics -- therapeutic use -- Periodicals; 616.994
• DOI: 10.1080/15360288.2021.1900492
• Languages: English
• ISSNs: 1536-0288

Abstract

Abstract: To identify potential areas for intervention and gain insight on current practice in patients who are tapered to zero morphine equivalent daily doses (MEDD) through the Pharmacy Pain E-Consult at a Veterans Healthcare System. This was done by describing the types of follow-up care and resources utilized by patients. This project is a retrospective chart review of Veterans with non-cancer pain on chronic-opioid therapy consulted to the pharmacy e-consult service and tapered to 0 MEDD. Descriptive statistics are collected one year pre-taper and one year post-taper. One year post-taper, approximately one-third of the patients were re-started on opioid therapy. However, average MEDD overall was significantly decreased one year post-taper compared to pre-taper. Average pain scores were not significantly different pre-taper compared to post-taper. Non-opioid medications generally increased post-taper. Follow-up with mental health and pain management clinical pharmacy specialists decreased post-taper. Tapering to zero MEDD did not lead to a significant increase in pain one-year post-taper; however, approximately 33% of patients were re-started on opioids within one year post-taper. Average MEDD scores decreased post-taper as expected but with effects on mental health being largely unknown, we believe that further study in this area will help us better support patients.