TY - JOUR
T1 - Compliance with opioid therapy
T2 - Distinguishing clinical characteristics and demographics among patients with cancer pain
AU - Koyyalagunta, Dhanalakshmi
AU - Bruera, Eduardo
AU - Engle, Mitchell P.
AU - Driver, Larry
AU - Dong, Wenli
AU - Demaree, Chris
AU - Novy, Diane M.
N1 - Publisher Copyright:
© 2017 American Academy of Pain Medicine. All rights reserved.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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.
AB - 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.
KW - Cancer Pain
KW - Opioid Compliance
KW - Opioid Misuse
KW - Opioids
KW - Urine Drug Testing
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U2 - 10.1093/pm/pnx178
DO - 10.1093/pm/pnx178
M3 - Article
C2 - 29016951
AN - SCOPUS:85055352391
SN - 1526-2375
VL - 19
SP - 1469
EP - 1477
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 7
ER -