• Mélanie Bérubé, Sébastien Dupuis, Stéphane Leduc, Isabel Roy, Valérie Turcotte, Caroline Côté, Sonia Grzelak, Sarah Clairoux, Stéphane Panic, and François Lauzier.
• Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada; Faculty of Nursing, Université Laval, Quebec City, Canada. Electronic address: melanie.berube@fsi.ulaval.ca.
• Pain Manag Nurs. 2022 Apr 1; 23 (2): 142-150.

BackgroundChronic opioid use has been documented in up to 20% of patients with traumatic injuries. Hence, we developed the Tapering Opioids Prescription Program for high-risk Trauma (TOPP-Trauma) patients.AimsTo assess the feasibility and acceptability of TOPP-Trauma, examine the feasibility of the research methods, and describe its potential efficacy in reducing long-term opioid use.DesignA two-arm pilot randomized controlled trial.MethodsFifty participants discharged home were assigned to TOPP-Trauma or an educational pamphlet. Feasibility was assessed based on ability to provide the program components. The acceptability was assessed with the Treatment Acceptability and Preference Questionnaire. The feasibility of the research methods was evaluated according to standard parameters. Self-reported morphine equivalent dose (MED) and MEDs supplied by pharmacies were measured at 6 and 12 weeks.ResultsEighty percent or more of TOPP-Trauma components were delivered as planned, and the program was deemed highly acceptable. Approximately 10% of screened patients were eligible. Eighty-five percent of eligible patients agreed to participate with 20% attrition rates. TOPP-Trauma participants used less MED/day compared to the control group at 6 and 12 weeks (1.2. vs. 12.2 mg; 0.4. vs 4.0 mg), and pharmacies supplied less than half of cumulative MEDs to those who received the program at 12 weeks, but the differences were not statistically significant.ConclusionsSome challenges need to be addressed before testing TOPP-Trauma. These include creating strategies to decrease attrition, offering the program throughout the care continuum to higher risk patients, and evaluating the impacts of reduced opioid use.Copyright © 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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