Evaluation of a patient-centred, multidisciplinary opioid tapering program for individuals with chronic non-cancer pain on long-term opioid therapy: a preliminary report
| dc.contributor.author | Ens, Karin | |
| dc.contributor.examiningcommittee | Leong, Christine (Pharmacy) | en_US |
| dc.contributor.examiningcommittee | Sabourin, Brigitte (Clinical Health Psychology) | en_US |
| dc.contributor.supervisor | Turcotte, Dana | |
| dc.date.accessioned | 2023-04-13T19:40:43Z | |
| dc.date.available | 2023-04-13T19:40:43Z | |
| dc.date.copyright | 2023-03-29 | |
| dc.date.issued | 2023-03-29 | |
| dc.date.submitted | 2023-03-30T03:24:26Z | en_US |
| dc.degree.discipline | Pharmacy | en_US |
| dc.degree.level | Master of Science (M.Sc.) | en_US |
| dc.description.abstract | Background: Opioid tapering is highlighted as a priority action to combat the Opioid Crisis in many Canadian practice guidelines, but there is sparse evidence on clinically safe and effective tapering, with less still on practical implementation strategies. Directed by these gaps, an interdisciplinary team with chronic pain expertise collaboratively developed “Evaluation of a Patient-Centered, Multidisciplinary Opioid Tapering Program for Individuals with Chronic Non-Cancer Pain on Long-Term Opioid Therapy”. With clinical utility at its core, outcomes and tools are developed to be meaningful to practice. Methods: Half of study participants are randomized to participate in a one-day, interprofessional patient education workshop (PEW), which includes pain and opioid education and a novel application of Acceptance and Commitment Therapy (ACT). The workshop’s impact is measured through pre- and post-questionnaires collecting data on opioid knowledge, tapering readiness, and feedback. Following the workshop, all participants begin a 12-month multidisciplinary opioid tapering program (MTP). Study pharmacists base each individualized program on starting dose, clinical picture, and participant goals, incorporating consistent and frequent follow-up and support. MTP impact is measured at weekly phone follow-ups and quarterly in-person visits. Opioid dose, pain, and health and wellbeing questionnaire scores are measured. This review summarizes results from the first 10 PEW participants and 16 patients to reach the MTP’s 3-month mark. Results: MTP: Sixteen participants had a 21.9% opioid reduction by month 3 of the 12-month program (p=0.007), without changes to other scores. In fact, pain and pain disability show trend reductions. PEW: PEW participants (n=10) demonstrated a 1.3-point improvement on the 6-point opioid knowledge quiz pre- and post-workshop (p=0.031). Tapering readiness improved among 40% of participants post-workshop, 30% remained “very ready” pre and post, 20% did not improve, and 10% decreased in readiness. 100% reported they’d use PEW teachings to manage pain, 78% felt the workshop provided value, and 50% were satisfied with the format. Conclusion: The opioid crisis shows no sign of slowing down and patient-focused, evidence-based strategies are urgently needed. This preliminary review demonstrates the strength of the overall project’s design, including interdisciplinary teams (pharmacists and psychologists) and close patient follow-up, as integral contributors in mitigating the opioid crisis. | en_US |
| dc.description.note | May 2023 | en_US |
| dc.description.sponsorship | Canadian Society of Hospital Pharmacists Research Fund | en_US |
| dc.identifier.uri | http://hdl.handle.net/1993/37279 | |
| dc.language.iso | eng | en_US |
| dc.rights | open access | en_US |
| dc.subject | opioid | en_US |
| dc.subject | taper | en_US |
| dc.subject | chronic pain | en_US |
| dc.title | Evaluation of a patient-centred, multidisciplinary opioid tapering program for individuals with chronic non-cancer pain on long-term opioid therapy: a preliminary report | en_US |
| dc.type | master thesis | en_US |
| local.subject.manitoba | no | en_US |
| oaire.awardNumber | UM53193 | en_US |
| oaire.awardTitle | Clinical Health Psychology Research Internal Grant | en_US |
| oaire.awardURI | n/a | en_US |
| project.funder.identifier | http://dx.doi.org/10.13039/100017552 | en_US |
| project.funder.name | Department of Clinical Health Psychology, University of Manitoba | en_US |