Compliance with opioid therapy: Distinguishing clinical characteristics and demographics among patients with cancer pain

Dhanalakshmi Koyyalagunta, Eduardo Bruera, Mitchell P. Engle, Larry Driver, Wenli Dong, Chris Demaree, Diane M. Novy

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background. Because an increase of patients who misuse opioids has been identified in our cancer clinical setting through urine drug testing (UDT) and the Screener and Opioid Assessment for Patient's with Pain-Short Form (SOAPP-SF), we conducted this retrospective cohort study to identify patient characteristics that are associated with UDT that indicates noncompliance. Methods. Over a two-year period, 167 of 8,727 patients (2.4%) seen in the pain clinic and who underwent UDT were evaluated to determine compliance with prescribed opioid regimens. Descriptive clinical and demographic data were collected, and group differences based on compliance with opioid therapy were evaluated. Results. Fifty-eight percent of the patients were noncompliant with their prescribed opioid therapy. Noncompliant patients were younger than compliant patients, with a median age of 46 vs 49 years (P 5 0.0408). Noncompliant patients were more likely to have higher morphine equivalent daily doses; however, the difference was not statistically significant. Patients with a history of alcohol (ETOH) (P 5 0.0332), illicit drug use (P 5 0.1014), and smoking (P 5 0.4184) were more likely noncompliant. Univariate regression analysis showed that a history of ETOH use (P 5 0.034), a history of anxiety (P 5 0.027), younger age (P 5 0.07), and a SOAPP-SF score of 4 or higher (P 5 0.05) were associated with an abnormal UDT. Conclusions. History of ETOH use, anxiety, high SOAPP-SF score, and younger age were associated with UDT that indicates noncompliance. Given the very small percentage of UDT testing, it is quite likely that a significant number of patients who did not undergo UDT were also nonadherent with treatment recommendations.

Original languageEnglish (US)
Pages (from-to)1469-1477
Number of pages9
JournalPain Medicine (United States)
Volume19
Issue number7
DOIs
StatePublished - Jul 1 2018

Keywords

  • Cancer Pain
  • Opioid Compliance
  • Opioid Misuse
  • Opioids
  • Urine Drug Testing

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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