Validation of a screener and opioid assessment measure for patients with chronic pain
Validation of a screener and opioid assessment measure for patients with chronic pain
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DOI：
10.1016/j.pain.2004.07.026
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发表时间：
2004-11-01
期刊：
影响因子：
7.4
通讯作者：
Jamison, RN
中科院分区：
文献类型：
--
作者：
Butler, SF;Budman, SH;Jamison, RN
治疗慢性疼痛患者的提供者需要一种简短的评估工具，以确定在开出止痛阿片类药物时的潜在滥用风险。这项研究的目的是为考虑长期接受阿片类药物治疗的慢性疼痛患者开发并开始验证自我给药筛查工具(疼痛患者的筛查和阿片类药物评估，SOAPP)。26位疼痛和成瘾专家在慢性疼痛患者的重要特征上达成了共识，这些特征使用概念图来预测未来的药物滥用。基于这一共识，开发了24项SOAPP(1.0版)，并对175名服用阿片类药物治疗慢性疼痛的患者进行了治疗。6个月后，对其中95名患者进行了重新评估。SOAPP的验证是通过确定那些表现出异常药物相关行为的患者进行的，这些行为由以下任何一项确定：处方药使用问卷(PDUQ)面谈中的阳性分数、尿毒学筛查阳性和/或工作人员对患者是否存在严重药物问题的评级。在最初的24个条目中，14个SOAPP条目似乎可以预测随后的异常行为。这14个项目的系数a在短量表上是可以接受的(0.74)。受试者工作特征曲线分析得出曲线下面积为0.881(P<；0.001)，提示筛查设备具有足够的灵敏度和特异度。这些可靠性和预测效度结果表明，SOAPP是筛查慢性疼痛患者滥用药物的潜在风险的有希望的一步。(C)2004年国际疼痛研究协会。爱思唯尔出版，版权所有。
There has been a need for a brief assessment tool for providers who treat chronic pain patients to determine potential risk of abuse when prescribed opioids for pain. The purpose of this study was to develop and begin the validation of a self-administered screening tool (Screener and Opioid Assessment for Patients with Pain, SOAPP) for chronic pain patients considered for long-term opioid therapy. A consensus of 26 pain and addiction experts was obtained on important characteristics of chronic pain patients that predict future medication misuse using concept mapping. A 24-item SOAPP (version 1.0) was developed based on this consensus and was administered to 175 patients who were taking opioids for chronic pain. After 6 months, 95 of these patients were re-evaluated. Validation of the SOAPP was conducted by identifying those patients exhibiting aberrant drug-related behavior as determined by any of the following: a positive score on the Prescription Drug Use Questionnaire (PDUQ) interview, positive urine toxicology screen, and/or ratings by staff as to whether patients had a serious drug problem. Of the original 24 items, 14 SOAPP items appeared to predict subsequent aberrant behaviors. Coefficient a for these 14 items was acceptable for a short scale (0.74). Receiver operating characteristics Curve analysis yielded an area under the curve of 0.881 (P < 0.001), suggesting adequate sensitivity and specificity for a screening device. These reliability and predictive validity results suggest that the SOAPP is a promising step toward screening risk potential for substance misuse among persons with chronic pain. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.