Identifying prescription opioid use disorder in primary care: Diagnostic characteristics of the Current Opioid Misuse Measure (COMM)
Identifying prescription opioid use disorder in primary care: Diagnostic characteristics of the Current Opioid Misuse Measure (COMM)
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DOI：
10.1016/j.pain.2010.11.006
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发表时间：
2011-02-01
期刊：
影响因子：
7.4
通讯作者：
Liebschutz, Jane M.
中科院分区：
文献类型：
--
作者：
Meltzer, Ellen C.;Rybin, Denis;Liebschutz, Jane M.
当前阿片类药物滥用测量（COMM）是对过去一个月异常药物相关行为的自我报告评估，已在专业疼痛管理患者中得到验证。在慢性疼痛的初级保健（PC）患者中评价了COMM的性能特征。假设COMM可以识别处方药使用障碍（PDD）患者。在一家城市安全网医院等待PC访问的讲英语的成年人，他们患有慢性疼痛，并在过去一年中接受过任何阿片类镇痛药处方，他们接受了COMM。复合国际诊断访谈作为“金标准”，使用DSM-IV标准进行PDD和其他物质使用障碍（SUD）。受试者工作特征（ROC）曲线显示了COMM的诊断测试特性。在238名参与者中，27名（11%）符合DSM-IV PDD标准，17名（7%）患有其他SUD，194名（82%）没有疾病。PDD患者的平均COMM评分高于所有其他患者（即，患有其他SUD或无疾病的患者，平均20.4 [ SD 10.8] vs 8.4 [SD 7.5]，P <0.0001）。COMM评分>= 13时，识别PDD患者的敏感性为77%，特异性为77%。ROC曲线下面积为0.84。对于处方阿片类药物的慢性疼痛患者，PDD的发展是一种不良并发症。在患有慢性疼痛处方阿片类药物的PC患者中，COMM是识别PDD患者的一种有前途的工具。(c)2010年国际疼痛研究协会。由Elsevier B出版。V.保留所有权利。
The Current Opioid Misuse Measure (COMM), a self-report assessment of past-month aberrant medication-related behaviors, has been validated in specialty pain management patients. The performance characteristics of the COMM were evaluated in primary care (PC) patients with chronic pain. It was hypothesized that the COMM could identify patients with prescription drug use disorder (PDD). English-speaking adults awaiting PC visits at an urban, safety-net hospital, who had chronic pain and had received any opioid analgesic prescription in the past year, were administered the COMM. The Composite International Diagnostic Interview served as the "gold standard," using DSM-IV criteria for PDD and other substance use disorders (SUDs). A receiver operating characteristic (ROC) curve demonstrated the COMM's diagnostic test characteristics. Of the 238 participants, 27 (11%) met DSM-IV PDD criteria, whereas 17 (7%) had other SUDs, and 194 (82%) had no disorder. The mean COMM score was higher in those with PDD than among all others (ie, those with other SUDs or no disorder, mean 20.4 [ SD 10.8] vs 8.4 [SD 7.5], P < .0001). A COMM score of >= 13 had a sensitivity of 77% and a specificity of 77% for identifying patients with PDD. The area under the ROC curve was 0.84. For chronic pain patients prescribed opioids, the development of PDD is an undesirable complication. Among PC patients with chronic pain-prescribed prescription opioids, the COMM is a promising tool for identifying those with PDD. (c) 2010 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.