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Implementation of an Opioid Weaning Protocol at a Tertiary Care Children's Hospital

Jenna Ford1, Aaron Harthan1, Jeremy McGarvey1

  • 1OSF HealthCare Children's Hospital of Illinois, Peoria, Illinois.

Hospital Pediatrics
|October 4, 2022
PubMed

Insights

Implementing a pharmacist-led opioid weaning protocol and the Withdrawal Assessment Tool-1 significantly reduced opioid wean duration and hospital stays in pediatric patients. This approach offers a standardized method for managing opioid withdrawal in children.

Area of Science:

  • Pediatric critical care medicine
  • Pharmacology
  • Clinical pharmacy

Background:

  • Opioid weaning in pediatric patients can be prolonged and complex.
  • Standardized protocols are needed to manage opioid withdrawal effectively.
  • Pharmacist involvement can optimize medication management.

Purpose of the Study:

  • To evaluate a pharmacist-managed opioid weaning regimen combined with an objective opioid withdrawal assessment tool.
  • To determine the impact on opioid wean duration, length of hospital stay, and withdrawal episodes.
  • To assess the feasibility of implementing this combined approach in pediatric care.

Main Methods:

  • Retrospective cohort study of 115 pediatric inpatients from 2012-2020.
  • Phased implementation: baseline, pharmacist-led weaning, and addition of the Withdrawal Assessment Tool-1 (WAT-1).
  • Data collected on wean duration, hospital length of stay, and opioid withdrawal episodes requiring rescue doses.

Main Results:

  • Significant reductions in total wean duration and hospital length of stay were observed from baseline to the intervention phase with WAT-1.
  • Episodes of opioid withdrawal requiring rescue medication also decreased significantly.
  • No significant differences in patient characteristics were noted between study phases.

Conclusions:

  • A pharmacist-managed opioid weaning regimen, enhanced by the WAT-1, significantly shortens opioid wean duration and hospital length of stay in pediatric patients.
  • This combined strategy demonstrates potential for widespread adoption and standardization in tertiary care children's hospitals.
  • Optimizing opioid withdrawal management can improve patient outcomes and resource utilization.
Abstract

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