41 - Characterizing patients after opioid taper in a VA Medical Center
Kathryn Muzzio1, Lisa Dragic1, Michael Chandler1, Jacob Painter1,2
1Central Arkansas Veterans Healthcare System, Little Rock, AR, USA. 2University of Arkansas for Medical Sciences, Little Rock, AR, USA
Purpose The purpose of this project was to identify potential areas for intervention by describing the types of follow-up care and resources utilized by patients and gain insight on current practice who are tapered to 0 morphine equivalent daily doses (MEDD) through the Pharmacy Pain E-Consult at a Veterans Healthcare System. Methods This project was a retrospective chart review of Veterans with non-cancer pain on chronic-opioid therapy consulted to the pharmacy e-consult service from October 1, 2017 to September 30, 2018 who were tapered to 0 MEDD. Descriptive statistics were collected one year pre-taper and one year post-taper. Results A total of 60 patients met inclusion criteria. One year post-taper, approximately one-third of the patients were re-started on opioid therapy. However, average MEDD overall was lower at one year post-taper compared to pre-taper. Reduction in pain scores was not significant pre-taper compared to post-taper. Adjuvant medications generally increased post-taper. Follow-up with mental health and pain management clinical pharmacy specialists decreased post-taper. Conclusions Tapering to 0 MEDD did not lead to a significant decrease in pain one-year post-taper. Approximately 33% of patients were re-started on opioids within one year post-taper. Average MEDD scores decreased post-taper. Continued follow-up with patients who are tapered to 0 MEDD is required in order to improve outcomes.