Opioid Taper Initiative from Inpatient Rehabilitation

Colton Hickman, DO (University of Pittsburgh Medical Center Department of Physical Medicine & Rehabilitation, Glenshaw, Pennsylvania); Isaiah Levy, MD; Maryanne Henderson, DO; Amanda L. Harrington, MD; Amit Sinha, MD; Maria Twichell, MD; James E. Eubanks, Jr., MD DC MS

Meeting: AAPM&R Annual Assembly 2021

Categories: Practice Management, Leadership, and Quality Improvement (2021)

Session Information

Session Title: AA 2021 Virtual Posters - Practice Management, Leadership, and Quality Improvement

Session Time: None. Available on demand.

Disclosures: Colton Hickman, DO: No financial relationships or conflicts of interest

Objective: To implement an interdisciplinary team approach to opioid tapering/discontinuation for the opioid naïve inpatient rehabilitation (IPR) patient population.

Design: Inclusion criteria: Opioid naïve patients admitted to inpatient rehabilitation on opioids to the General and Spinal Cord Injury Inpatient Rehabilitation Units (post-surgical, trauma, burns, etc.). Known exclusions: Chronic opioid users. Pre-intervention timeframe: 6 months (June – Nov. 2019). Intervention timeframe: 6 months (June – Nov. 2020).Setting : The General (14 beds) and Spinal Cord Injury (20 beds) Inpatient Rehabilitation Units.Participants : The inpatient rehabilitation interdisciplinary team: Attending physicians, residents, nursing, therapists, and care managers.

Interventions: During weekly inpatient rehabilitation staffing the interdisciplinary team would address an “opioid taper plan (OTP)” that was meant to be brief and draw attention to the issue. In addition, providers were encouraged to regularly discuss the opioid taper plan with their patients while rounding.

Main Outcome Measures: We compared pre-interventional and interventional data. We calculated the percentage of opioid taper accomplished during IPR and the percentage of opioid naïve patients discharged with an opioid prescription.

Results: Pre-interventional versus interventional data demonstrated an 11% reduction in opioid prescriptions at IPR discharge for opioid naïve patients. There was also a 16% reduction in the maximum daily morphine milligram equivalent initially prescribed at IPR admission. An anonymous survey was conducted for IPR attending physicians, residents, and care managers who participated in the project and the vast majority of respondents found this project to be beneficial towards patient care.Conclusions: This project demonstrates that an interdisciplinary team-based approach to opioid tapering during IPR can help prevent excess opioid prescribing during IPR and reduce opioid prescriptions into the community at discharge.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Hickman C, Levy I, Henderson M, Harrington AL, Sinha A, Twichell M, Eubanks JE. Opioid Taper Initiative from Inpatient Rehabilitation [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/opioid-taper-initiative-from-inpatient-rehabilitation/. Accessed November 21, 2024.

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