title: Survey of opioid tapering practices of pediatric healthcare providers: A national perspective.
abstract: 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.
authors.affiliation: PANDA Team, Palliative Care, Division of Hospitalist Medicine, Children's National Medical Center, Washington, DC.
authors.forename: Fisher
authors.initials: F
authors.lastname: Deborah
authors.affiliation: Virginia Commonwealth University School of Nursing, Richmond, Virginia.
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: Ameringer
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D010818:Practice Patterns, Physicians'
chemical_list: D000701:Analgesics, Opioid