Could New Screening Tools Help Curb Opioid Misuse in Primary Care?
The study followed 177 patients from primary care centers for 6 months.
A recent study published in The Journal of Pain evaluated the effectiveness of a brief self-assessment tool called the Opioid Compliance Checklist (OCC) in identifying adherence, or misuse, among patients prescribed opioids. Patients were classified as having a positive or negative Drug Misuse Index based on urine toxicology screens, physician misuse behavior ratings, and patient's own OCC answers.
The study, by Jamison RN, Martel MO, Huang, C-C, Jurcik D, Edwards RR and full title: Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients on Opioid Therapy in Primary Care, followed 177 patients from 8 different primary care centers for 6 months. Each patient completed the 8-question, yes or no answer, opioid compliance checklist. Although the sample size was small, the raw data showed the OCC to be a helpful tool in detecting current and future drug misuse.
Results highlighted two questions for being most accurate for identifying opioid misuse at baseline. These inquired whether the patient ran out of their opioid medication early (Q. 5), and whether they missed their scheduled medical appointments (Q. 6). After the third round of the OCC was completed, a third question — inquiring as to whether patients ran out of their medication (Q. 1) — also became an identifier of misuse.
Those sample patients who completed the OCC each month for 6 months had fewer misuse behaviors by the end of the study, compared with others who completed it infrequently. The authors hypothesize that the regularity of a once-a-month reminder of responsible medication use — such as the OCC — may help with patient compliance.
The numbers of opioid related deaths in the US have sky-rocketed in recent decades, leading to the current situation being described as an epidemic. The numbers back the claim up; in 1991 there were 76 million Americans with opioid prescriptions for pain, in 2011 that number stood at 219 million. The consequence is a need for better monitoring of opioid compliance.
Jamison R, Martel M, Huang C, Jurcik D, Edwards R. Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients on Opioid Therapy in Primary Care. J. Paiin. 2015. doi:10.1016/j.jpain.2015.12.004.