• Kathryn Muzzio, Michael Chandler, Jacob T Painter, and Lisa Dragic.
• Kathryn Muzzio, PharmD, BCPS, Michael Chandler, PharmD, BCGP, and Lisa Dragic, PharmD, BCPS, are with the Pharmacy, Central Arkansas Veterans Healthcare System, John L. McClellan Memorial Veterans Hospital, Little Rock, Arkansas, USA; Jacob T. Painter, PharmD, MBA, PhD, is with the Core Investigator, Center for Mental Healthcare & Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR Director and Associate Professor, Division of Pharmaceutical Evaluation & Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
• J Pain Palliat Care Pharmacother. 2021 Jun 1; 35 (2): 84-90.

AbstractTo identify potential areas for intervention and gain insight on current practice in patients who are tapered to zero morphine equivalent daily doses (MEDD) through the Pharmacy Pain E-Consult at a Veterans Healthcare System. This was done by describing the types of follow-up care and resources utilized by patients. This project is a retrospective chart review of Veterans with non-cancer pain on chronic-opioid therapy consulted to the pharmacy e-consult service and tapered to 0 MEDD. Descriptive statistics are collected one year pre-taper and one year post-taper. One year post-taper, approximately one-third of the patients were re-started on opioid therapy. However, average MEDD overall was significantly decreased one year post-taper compared to pre-taper. Average pain scores were not significantly different pre-taper compared to post-taper. Non-opioid medications generally increased post-taper. Follow-up with mental health and pain management clinical pharmacy specialists decreased post-taper. Tapering to zero MEDD did not lead to a significant increase in pain one-year post-taper; however, approximately 33% of patients were re-started on opioids within one year post-taper. Average MEDD scores decreased post-taper as expected but with effects on mental health being largely unknown, we believe that further study in this area will help us better support patients.

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