Prescription Opioid Misuse Index in sickle cell patients: A brief questionnaire to assess at-risk for opioid abuse

Author Department

Internal Medicine; Medicine

Document Type

Article, Peer-reviewed

Publication Date

7-2019

Abstract

OBJECTIVE:

To develop a survey instrument to identify adult sickle cell disease (SCD) patients on chronic opioid therapy who are at-risk for opioid abuse.

DESIGN:

Prospective survey and interview.

SETTING:

Adult SCD clinic in a large urban teaching facility.

PATIENTS/PARTICIPANTS:

Convenience sampling of adult patients presenting to the sickle cell clinic.

INTERVENTIONS:

None.

MAIN OUTCOME:

Primary outcome was "at-risk for opioid misuse," defined as at least 3/8 "yes" answers (a positive composite score) on the Prescription Opioid Misuse Index (POMI) questionnaire. Secondary outcome was DSM-IV criteria for substance abuse using the DSM IV Diagnostic Interview Schedule.

RESULTS:

Of the 99 patients who completed the POMI, the mean age was 36 years; 58.6 percent were female, 48 percent were hemoglobin SS (47/99), and 26 percent were SC (26/99). Twenty-four percent (24/99) were identified as at-risk for opioid misuse using the POMI. There were no differences in demographic, SCD genotype, or socioeconomic variables for at-risk versus not-at-risk patients.

CONCLUSION:

Twenty-four percent of unselected adult SCD patients on opioids were identified as at-risk for opioid misuse using a quick survey. This may represent as much as 2.5-7 times the national misuse rate. This group of patients may benefit from additional diagnostic and therapeutic interventions to help understand and manage their opioid usage.

PMID

31637684

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