Feb 2018
Opioid Tapering
Introduction
In 2015, approximately 2 million Ontarians filled an opioid prescription from various sources within the healthcare system. Use the Opioid Tapering Template to evaluate opioid therapies and reduce opioid dosages in safe and effective ways.
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Information
About the tool
Revaluating opioid therapy and discussing opioid tapering with patients can be challenging. This tool recognizes that opioid tapering is a complex process, which requires ongoing discussion and support, individualizing tapering plans and prioritizing patient safety and self-efficacy. The Opioid Tapering Template is designed to assist family physicians and primary care nurse practitioners on developing tapering plans with their patients and adjusting those plans as their patients’ needs change due to pain, function and withdrawal symptoms.
The tool is divided into five sections to guide providers through the opioid tapering process:
- Important considerations for opioid tapering.
- How to taper, reduce or discontinue.
- Withdrawal symptoms & management.
- Tapering plan; and
- Follow-up tapering visits.
Throughout the tool, providers will find helpful talking points, fillable forms and links to relevant resources including those created by the CEP as part of its pain management suite of clinical tools. These clinical tools aim to provide primary care providers an overview of safe and effective opioid use, and appropriate pain management.
The Opioid Tapering Template was developed using the CEP’s integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. Clinical leadership of the resource was provided by Dr. Arun Radhakrishnan. End-users and clinical experts were also engaged to provide feedback.
The Opioid Tapering Template is based on the 2017 Canadian Guideline for Opioids for Chronic Pain.
The Opioid Tapering Template is one of several clinical tools developed as part of the Knowledge Translation in Primary Care Initiative. This multi-year initiative was a collaboration between the Centre for Effective Practice, Ontario College of Family Physicians (OCFP), and Nurse Practitioners’ Association of Ontario (NPAO). Funded by the Ministry of Health and Long-Term Care, this initiative supports primary care providers with the development of a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative (KTinPC).
Clinical leads
Arun Radhakrishnan
MD, CM, MSC, CCFP
Dr. Arun Radhakrishnan is a family physician with a focused clinical practice in chronic pain. He is an Assistant Professor with the Department of Family Medicine at the University of Ottawa and the University of Toronto. He is affiliated with The Ottawa Hospital and the Elisabeth Bruyere hospital and is an investigator at the Bruyere Research Institute and the Equity in Health Systems Lab. His research and education interests are in knowledge translation mentoring and digital health technologies. He has led the development of several award-winning educational programs, clinical practice tools and resources to support primary care management of chronic pain. He is a past AMS Phoenix Fellow and is currently the Medical Director of the Adaptive Mentoring Networks with the Centre for Effective Practice.
Dr. Radhakrishnan provided clinical leadership for the development of the chronic non-cancer pain topic and was offered compensation for his role.
Conflict of interest
The clinical lead received compensation for his role.
Focus group and usability participants received a small token of appreciation (e.g. gift certificate).
Expert Reviewers
Usability participants received a token of appreciation (e.g., gift certificate).
Additional resources
Factors that Increase or Decrease the Experience of Pain
Patient handout