Faculty Collaboration Database

Re-assessing the Validity of the Opioid Risk Tool in a Tertiary Academic Pain Management Center Population. Pain Med 2018 Jul 01;19(7):1382-1395

Date

02/07/2018

Pubmed ID

29408996

Pubmed Central ID

PMC7191882

DOI

10.1093/pm/pnx332

Scopus ID

2-s2.0-85055317466 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

OBJECTIVE: To analyze the validity of the Opioid Risk Tool (ORT) in a large. diverse population.

DESIGN: A cross-sectional descriptive study.

SETTING: Academic tertiary pain management center.

SUBJECTS: A total of 225 consecutive new patients, aged 18 years or older.

METHODS: Data collection included demographics, ORT scores, aberrant behaviors, pain intensity scores, opioid type and dose, smoking status, employment, and marital status.

RESULTS: In this population, we were not able to replicate the findings of the initial ORT study. Self-report was no better than chance in predicting those who would have an opioid aberrant behavior. The ORT risk variables did not predict aberrant behaviors in either gender group. There was significant disparity in the scores between self-reported ORT and the ORT supplemented with medical record data (enhanced ORT). Using the enhanced ORT, high-risk patients were 2.5 times more likely to have an aberrant behavior than the low-risk group. The only risk variable associated with aberrant behavior was personal history of prescription drug misuse.

CONCLUSIONS: The self-report ORT was not a valid test for the prediction of future aberrant behaviors in this academic pain management population. The original risk categories (low, medium, high) were not supported in the either the self-reported version or the enhanced version; however, the enhanced data were able to differentiate between high- and low-risk patients. Unfortunately, without technological automation, the enhanced ORT suffers from practical limitations. The self-report ORT may not be a valid tool in current pain populations; however, modification into a binary (high/low) score system needs further study.

Author List

Clark MR, Hurley RW, Adams MCB

Author

Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Opioid-Related Disorders
Pain Management
Risk Factors
Self Report