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Pain Pract. 2017 Mar;17(3):366-370. doi: 10.1111/papr.12457. Epub 2016 May 10.

Physician and Patient Survey of Taper Schedule and Family Physician Letters Following Discharged from the Acute Pain Service.

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Department of Anaesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.



Following discharge, patients requiring high opioid doses may be at risk for both under- and overdosing, posing a major challenge to community physicians. The aim of this study was to examine the effectiveness and degree of satisfaction with a personalized taper schedule and physician letter through interviews of patients and physicians.


This was a 1-year prospective study. Following ethics approval and informed written consent, patients admitted for elective surgery, 18 to 60 years of age, receiving opioid analgesics, were recruited. Prior to discharge, the acute pain service team provided patients with a taper schedule explained in detail. Individualized physician letters were faxed to treating family physicians. Patients were contacted by phone 2, 4, and 6 weeks after discharge. Physicians were contacted once, a month after discharge. Patients and physicians were asked to grade the taper schedule on a 1- to 5-point Likert scale. Questions pertained to clarity, usefulness, ability to follow the instructions, and general satisfaction.


Twenty-six patients and 21 physicians completed the study. Physicians were generally satisfied with both the taper schedule and letter and rated all aspects between 3.76 and 4.38 of 5. Similarly, patients were satisfied with the taper schedule and rated all aspects between 4.08 and 4.5.


Both physicians and patients generally found the taper schedule and letter helpful in assisting them to taper off their opioid use. This is one way of bridging the gap in continuity of care between the acute and primary care providers while reducing the risk to patients during the transition period.


acute pain service; continuity of care; physician letters; taper schedule; transfer of care

[Indexed for MEDLINE]

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