Evaluation and comparison of tools for diagnosing problematic prescription opioid use among chronic pain patients
Evaluation and comparison of tools for diagnosing problematic prescription opioid use among chronic pain patients
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DOI：
10.1002/mpr.1542
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发表时间：
2017-12-01
影响因子：
3.1
通讯作者：
Lev-Ran, Shaul
中科院分区：
文献类型：
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作者：
Kovatch, Merav;Feingold, Daniel;Lev-Ran, Shaul
处方阿片类药物通常用于治疗慢性疼痛。对疼痛患者中有问题的阿片类药物使用的评估在各研究中不一致，部分原因是各种措施之间的差异。因此，最合适的衡量标准往往不明确。在这项研究中，我们使用三份问卷评估了551名接受慢性疼痛治疗的个体的阿片类药物使用问题：酒精使用障碍和相关残疾访谈计划-第四版（AUDADIS-IV），当前阿片类药物滥用测量（COMM）问卷和Portenoy标准（PC）。这些问卷调查得出的有问题用途：的阳性率不一致：分别为52.6%、28.7%和17.1%，排除AUDADIS-IV标准的耐受性和戒断症状后，阳性率没有实质性变化。虽然这三份问卷都有一些统计上相关的基于内容的一致性问题，但基于结构特征，包括问卷的参考时间范围，问题的措辞和回答选择，对它们的积极回答率显着不同。本研究的结果说明了AUDADIS-IV，COMM和PC在诊断患有慢性疼痛的成人人群中有问题的阿片类药物使用方面的优势和局限性，并强调了在识别该人群中有问题的阿片类药物使用时认识和解决特定问卷和问题相关差异的重要性。
Prescription opioid medications are commonly used for the treatment of chronic pain. Assessments of problematic opioid use among pain patients are inconsistent across studies, partially due to differences between various measures. Therefore, the most appropriate measure to use is often unclear. In this study we assessed problematic opioid use in a sample of 551 individuals receiving treatment for chronic pain, using three questionnaires: the Alcohol Use Disorder and Associated Disabilities Interview Schedule - Fourth Edition (AUDADIS-IV), the Current Opioid Misuse Measure (COMM) questionnaire and Portenoy's criteria (PC). These questionnaires yielded discordant positive rates of problematic use: 52.6%, 28.7%, and 17.1%, respectively, which did not change substantially when excluding AUDADIS-IV criteria of physical symptoms of tolerance and withdrawal. Although these three questionnaires share some statistically correlated content-based congruent questions, positive response rates to them were significantly different based on construction features, including questionnaires' referred time-frame, wording of questions and response alternatives. The findings of the present study illustrate strengths and limitations of the AUDADIS-IV, COMM and PC in diagnosing problematic opioid use in a population of adults suffering from chronic pain, and highlight the importance of recognizing and addressing specific questionnaire and question-related differences when identifying problematic opioid use in this population.