Development and validation of the current opioid misuse measure
Development and validation of the current opioid misuse measure
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DOI：
10.1016/j.pain.2007.01.014
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发表时间：
2007-07-01
期刊：
影响因子：
7.4
通讯作者：
Jamison, Robert N.
中科院分区：
文献类型：
--
作者：
Butler, Stephen F.;Budman, Simon H.;Jamison, Robert N.
临床医生认识到在给慢性疼痛患者开具阿片类药物治疗时监测其异常用药相关行为的重要性。本研究的目的是为那些已经接受长期阿片类药物治疗的疼痛患者开发并验证当前阿片类药物滥用测量工具（COMM）。在26名疼痛管理和成瘾专家的参与下，初步形成了177个条目。概念图谱确定了药物滥用背后的六个主要概念，并用于构建初始条目库。22名疼痛和成瘾专家对这些条目进行了重要性和相关性评级，从而选出了一个包含40个条目的COMM初始版本。最终条目的选择是基于对因慢性非癌性疼痛服用阿片类药物的患者（N = 227）进行的实证评估。对55名参与者进行了一周的重测信度检验。所有参与者都接受了COMM初始版本、处方药使用问卷（PDUQ）访谈，并提交了尿液样本进行毒理学筛查。还获取了医生对患者异常行为的评级。在40个条目中，有17个条目似乎能够充分测量异常行为，显示出良好的内部一致性和重测信度。通过受试者工作特征（ROC）曲线分析检验了临界值分数，并确定了合理的敏感度和特异度。为了评估COMM捕捉患者状态变化的能力，对一部分患者（N = 86）进行了测试，并在三个月后对其进行了随访和重新评估。研究发现COMM作为一种简短的、自我报告当前异常药物相关行为的测量工具是有前景的。这些初步结果的进一步交叉验证和重复研究仍在进行中。（C）2007国际疼痛研究协会。由爱思唯尔出版集团出版。保留所有权利。
Clinicians recognize the importance of monitoring aberrant medication-related behaviors of chronic pain patients while being prescribed opioid therapy. The purpose of this study was to develop and validate the Current Opioid Misuse Measure (COMM) for those pain patients already on long-term opioid therapy. An initial pool of 177 items was developed with input from 26 pain management and addiction specialists. Concept mapping identified six primary concepts underlying medication misuse, which were used to develop an initial item pool. Twenty-two pain and addiction specialists rated the items on importance and relevance, resulting in selection of a 40-item alpha COMM. Final item selection was based on empirical evaluation of items with patients taking opioids for chronic, noncancer pain (N = 227). One-week test-retest reliability was examined with 55 participants. All participants were administered the alpha version of the COMM, the Prescription Drug Use Questionnaire (PDUQ) interview, and submitted a urine sample for toxicology screening. Physician ratings of patient aberrant behaviors were also obtained. Of the 40 items, 17 items appeared to adequately measure aberrant behavior, demonstrating excellent internal consistency and test-retest reliability. Cutoff scores were examined using ROC curve analysis and reasonable sensitivity and specificity were established. To evaluate the COMM's ability to capture change in patient status, it was tested on a subset of patients (N = 86) that were followed and reassessed three months later. The COMM was found to have promise as a brief, self-report measure of current aberrant drug-related behavior. Further cross-validation and replication of these preliminary results is pending. (C) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.