A Comparison of Various Risk Screening Methods in Predicting Discharge From Opioid Treatment

OBJECTIVESRisk assessment and stratification has become an important aspect of the prescribing of opioids to patients with chronic pain. There is little empirical data available on the sensitivity and specificity of commonly used risk assessment tools. This paper describes 2 studies that compare the...

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Bibliographic Details
Published in:	The Clinical journal of pain Vol. 28; no. 2; pp. 93 - 100
Main Authors:	Jones, Ted, Moore, Todd, Levy, Jacob L, Daffron, Susan, Browder, Joe H, Allen, Leslie, Passik, Steven D
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-02-2012 Lippincott Williams & Wilkins
Subjects:	Adult Aged Analgesics, Opioid - therapeutic use Biological and medical sciences Comorbidity Female Fundamental and applied biological sciences. Psychology Humans Immunomodulators Male Mass Screening - methods Mass Screening - statistics & numerical data Medical sciences Middle Aged Neurology Opioid-Related Disorders - diagnosis Opioid-Related Disorders - epidemiology Opioid-Related Disorders - prevention & control Pain - diagnosis Pain - drug therapy Pain - epidemiology Pain Measurement - drug effects Pain Measurement - methods Pain Measurement - statistics & numerical data Pharmacology. Drug treatments Prevalence Prognosis Reproducibility of Results Risk Assessment - methods Risk Factors Sensitivity and Specificity Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors Tennessee - epidemiology Vertebrates: nervous system and sense organs Young Adult Tennessee Nociception risk assessment Nervous system diseases Clinical management Pain Treatment aberrant drug-related behavior opioid pain management Risk factor Medical screening Comparative study Behavioral disorder
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Summary:	OBJECTIVESRisk assessment and stratification has become an important aspect of the prescribing of opioids to patients with chronic pain. There is little empirical data available on the sensitivity and specificity of commonly used risk assessment tools. This paper describes 2 studies that compare the prediction capabilities of various risk assessment tools. METHODSThe first study presents data on patients at a pain practice whose treatment with opioids was stopped due to their engaging in aberrant drug-related behavior. Patients were assessed with the Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP-R), the Pain Medication Questionnaire, the Opioid Risk Tool, and a clinical interview. A second study compared the risk assessment measures, SOAPP-R, Pain Medication Questionnaire, Opioid Risk Tool, and a clinical interview. Data were gathered on whether patients had engaged in aberrant drug-related behavior at 6-month follow-up. RESULTSSignificant differences in the measures were found. Accuracy did not appear to be a function of the type of aberrant drug-related behavior that the patient engaged in for any of the measures. The clinical interview showed the best sensitivity of the 4 risk measures in predicting risk. The SOAPP-R showed the best sensitivity of the self-report measures. However, the SOAPP-R appears to overrate risk. DISCUSSIONOverall, these studies indicate that not all risk assessment tools are equal in their ability to accurately predict future aberrant drug-related behavior. It may be that written risk assessment tools that use more subtle items are better suited to certain patient populations.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0749-8047 1536-5409
DOI:	10.1097/AJP.0b013e318225da9e