Deborah Fisher, Ameringer Suzanne W
PANDA Team, Palliative Care, Division of Hospitalist Medicine, Children's National Medical Center, Washington, DC.
Virginia Commonwealth University School of Nursing, Richmond, Virginia.
J Opioid Manag. 2017 Jan/Feb;13(1):59-64. doi: 10.5055/jom.2017.0368.
The purpose of this study was to describe the current opioid tapering practice.
Cross-sectional, online, survey research.
Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves.
One hundred four participants responded to the survey. The respondents were predominantly physicians (n = 58, 62 percent). The majority of respondents worked in an academic children's medical center (n = 50, 52 percent). The average number of years in pediatric practice was 16 (mean = 16.33, range of 0-45 years). Of the 104 respondents, only 22 (27 percent) had a written protocol for opioid tapering. Use of expert consultants such as pharmacists or pediatric pain management teams varied. The majority of respondents (n = 46, 44 percent) seldom or never consult a pharmacist. Only 22 percent (n = 17) almost always or always consult a pediatric pain team. There was a wide range of personal tapering rate preferences.
This study provided a baseline assessment of pediatric opioid tapering practices by pediatric healthcare providers. Results revealed a marked variation in practice patterns that may indicate deficits in the assessment and management of opioid withdrawal in children. The need for the development of assessment-based opioid tapering guidelines for the pediatric population is long overdue.
