Simpkins S, Gilmer H and Lyon J
This retrospective review of patients at the MedStar National Rehabilitation Hospital analyzed patient health records to determine if immediate release opioid pain medications were being administered effectively for breakthrough pain management with this patient population. The Cerner PowerChart system was utilized to identify 77 patients that had received immediate release opioid medication to treat breakthrough pain. Orthopedic rehabilitation patients were identified as the primary users of opioid breakthrough pain medication doses at the facility (47%). When all breakthrough pain patients were examined, it was determined that the immediate release opioids being administered were significantly effective in treating patient pain with 88.8% of the doses achieving at least a 27.3% reduction in perceived patient pain on an 11-point numeric rating scale. Additionally, it was determined that 71.4% of the orthopedic rehabilitation patients were dose tapered by at least 50% during the inpatient stay. These results indicate that the treatment of acute pain at the hospital demonstrates a clinically significant analgesic response while doses are tapered appropriately to minimize opioid exposure.