- Sustained opioid reduction in chronic pain patients with higher-dose, long-term opioid therapy was almost 4 times more likely if their general practitioners (GPs) developed and documented an opioid taper plan.
- Taper plans that included behavioral health visits, receipt of gabapentin/pregabalin, and antidepressants or antianxiety medication were more likely to succeed.
Why this matters
- Data on the effectiveness of taper plans in primary care practice are lacking.
- Evidence suggests that GPs may be reluctant to implement such plans.
- In some EU countries, opioid prescribing patterns are shifting.
- Nested case-control study (sustained opioid taper, n=894; without sustained taper/controls, n=3576).
- Funding: Purdue Pharma.
- Sustained taper:
- Average daily opioid dose of ≤30 mg morphine equivalent (MME; with discontinuation as a special case); and/or
- At least a 50% reduction in MME from the patient’s nearest peak opioid average dose.
- A significant association between opioid taper plan and sustained taper was noted: OR, 3.63 (P<.0001>
- Taper plans associated with sustained taper (Pboth<.0001 style="list-style-type:circle;">
- Taper plans from prescription instructions: aOR, 4.03; and
- Taper plans from clinical encounter notes: aOR, 2.82.
- Data on medications outside this specific clinical system are unknown.
Coauthored with Chitra Ravi, MPharm