Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 7
Disclosures: Neha A. Shah, DO: Nothing to disclose.
Objective: To determine if weaning from opioids has an effect on outcomes in an interdisciplinary cognitive behavioral comprehensive pain management program (CPMP).
Design: Retrospective chart review of consecutive patients enrolled in Marianjoy CPMP from September 2017 to April 2018.
Setting: Outpatient Integrative Pain Clinic
Participants: 31 consecutive patients entered an outpatient 21-day Interdisciplinary Comprehensive Pain Management Program (CPMP) on opioids.
Intervention : 21-day interdisciplinary cognitive behavioral program that combined one-on-one and group therapies. Program included MD oversight, physical therapy (PT), psychology, daily pain science education, spiritual care. PT included individualized therapeutic exercise, functional training, neurosensory reeducation, manual therapy. Program provided patients with the tools to allow them better manage their pain with decreased reliance on opioids.
Main Outcome Measures: Collected at the beginning and conclusion of the program: Patient Specific Functional Scale 10-point scale, based on patient’s goals (0= unable to perform, 10 = able to perform at pre-injury level); Minimal Detectable Change (MDC)= 2 points. Global Rating of Change (GRC) -7 to +7 scale (at discharge only); MCID= +4 points. Morphine Equivalent Dosage (MED). Downtime in the first 12 hours of the day. Collected at the beginning and conclusion of the program and 3 months after D/C: Pain: Numeric Pain Rating Scale (0-10). Physical Ability: self-rating of current physical ability on 5-point Likert scale.
Results: 19 patients chose to wean (W), 12 patients chose not to wean (NW). Patients who weaned had greater functional gains and less pain that continued to improve after the program. The majority of patients verbally stated that they continued to wean under the supervision of their referring MD after the program.
Conclusions: Opioid weaning while undergoing a CPMP may improve outcomes regarding pain and perceived physical ability compared to patients who choose not to wean. This greater level of improvement may be due to opioid induced hyperalgesia.
Level of Evidence: Level II
To cite this abstract in AMA style:Shah NA, Katta S, Schwarz L. Weaning from Opioids Can Improve Patient Outcomes in an Interdisciplinary Comprehensive Pain Management Program (CPMP) [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/weaning-from-opioids-can-improve-patient-outcomes-in-an-interdisciplinary-comprehensive-pain-management-program-cpmp/. Accessed January 25, 2022.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/weaning-from-opioids-can-improve-patient-outcomes-in-an-interdisciplinary-comprehensive-pain-management-program-cpmp/