Disclosures: Randolph L. Roig, MD: No financial relationships or conflicts of interest

Objective: To examine the effectiveness of a brief interdisciplinary pain evaluation program (PEP) on anxiety, depression, pain intensity, and interference

Design: Retrospective Cohort StudySetting : A single outpatient clinic at a Veterans Affairs Medical CenterParticipants : 317 patients who had voluntary LTOT tapers in a PEP from 2017 to 2019 during a 12-month treatment period

Interventions: Patients attended 3 appointments where opioid taper schedules were developed to reduce daily morphine milligram equivalent (MME) < 40. During these appointments, veterans met with a social worker, pharmacist, physician assistant, and physician to develop an individualized pain management plan including physical therapy, psychotherapy, and interventional pain management referrals.

Main Outcome Measures: Data were gathered on self-report indices including the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pain, Enjoyment of Life, and General Activity Scale (PEG). Data assessed at initial, 3, and 12-month appointments. Chi-square tests for independence and a series of mixed between-within subject ANOVAs were conducted to examine group differences in daily MME, anxiety, depression, pain intensity, and interference.

Results: 52% of patients were considered to be treatment completers if they attended all three appointments for taper goals. Results showed sustained improvements (p < 0.001) in anxiety, depression, pain intensity, and interference over time with no group differences. Effect sizes ranged from medium to large.Conclusions: When clinicians discuss the risks and benefits of opioid tapers, these results suggest that opioid tapers have long-term benefits in anxiety, depression, pain intensity, and interference. Future research should focus on opioid taper rates, long-term outcomes, and guidelines to expand individualized evidence-based opioid tapers.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/veteran-opioid-tapers-a-retrospective-chart-review/