Citation

Weiner SG, Horton LC, Green TC, Butler SF. Drug Alcohol Depend. 2015; 159: 152-157.

Affiliation

Inflexxion, Inc., Newton, MA, United States. Electronic address: sfbutler@inflexxion.com.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2015.12.007

PMID

26743334

Abstract

OBJECTIVES: This study aimed to: (a) determine the percentage of ED patients receiving prescriptions for opioid pain medications that meet the criteria for "high-risk for abuse potential" on the Screener and Opioid Assessment for Patients with Pain (SOAPP(®)-R), (b) determine the percentage of patients with high-risk behavior on the state prescription drug monitoring program (PDMP) database, (c) compare the SOAPP-R with data from the PDMP, and (d) determine psychometric properties of SOAPP-R for ED patients METHODS: Convenience sample of ED patients who were being considered for discharge with a prescription for an opioid pain medication. Subjects completed SOAPP-R on an electronic tablet and PDMP data was obtained. Scores on SOAPP-R ≥18 were defined as "at-risk", and PDMP data showing both ≥4 opioid prescriptions and ≥4 providers in 12 months was considered the criterion standard for high-risk behavior.

RESULTS: 82 patients (88.2%) provided consent. 32.9% (n=27) were determined to be "at-risk" (score ≥18) by SOAPP-R. 15.9% (n=13) subjects met PDMP criteria and 53.9% (n=7) of those had SOAPP-R scores ≥18 (sensitivity 54%, specificity 71%, positive predictive value 26%, negative predictive value 89%). The association of an at-risk SOAPP-R score and PDMP high-risk criteria was an adjusted odds ratio of 1.39 (95% confidence interval 0.73-3.68).

CONCLUSIONS: In our population, about one-third of patients being considered for discharge with an opioid prescription scored "at-risk" on SOAPP-R and 15.9% met the PDMP high-risk criteria. The high negative predictive value of SOAPP-R indicates it may be a useful screening tool for the ED patient population.

Language: en