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Development of a brief tool for monitoring aberrant behaviours among patients receiving long-term opioid therapy: The Opioid-Related Behaviours In Treatment (ORBIT) scale

Citation

Larance, B and Bruno, RB and Lintzeris, N and Degenhardt, L and Black, E and Brown, A and Nielsen, S and Dunlop, A and Holland, R and Cohen, M and Mattick, RP, Development of a brief tool for monitoring aberrant behaviours among patients receiving long-term opioid therapy: The Opioid-Related Behaviours In Treatment (ORBIT) scale, Drug and Alcohol Dependence: An International Journal on Biomedical and Psychosocial Approaches, 159 pp. 42-52. ISSN 0376-8716 (2016) [Refereed Article]

Copyright Statement

Copyright 2015 Elsevier Ireland Ltd.

DOI: doi:10.1016/j.drugalcdep.2015.11.026

Abstract

BACKGROUND: Early identification of problems is essential in minimising the unintended consequences of opioid therapy. This study aimed to develop a brief scale that identifies and quantifies recent aberrant behaviour among diverse patient populations receiving long-term opioid treatment.

METHOD: 40 scale items were generated via literature review and expert panel (N=19) and tested in surveys of: (i) N=41 key experts, and (ii) N=426 patients prescribed opioids >3 months (222 pain patients and 204 opioid substitution therapy (OST) patients). We employed item and scale psychometrics (exploratory factor analyses, confirmatory factor analyses and item-response theory statistics) to refine items to a brief scale.

RESULTS: Following removal of problematic items (poor retest-reliability or wording, semantic redundancy, differential item functioning, collinearity or rarity) iterative factor analytic procedures identified a 10-item unifactorial scale with good model fit in the total sample (N=426; CFI=0.981, TLI=0.975, RMSEA=0.057), and among pain (CFI=0.969, TLI=0.960, RMSEA=0.062) and OST subgroups (CFI=0.989, TFI=0.986, RMSEA=0.051). The 10 items provided good discrimination between groups, demonstrated acceptable test-retest reliability (ICC 0.80, 95% CI 0.60-0.89; Cronbach's alpha=0.89), were moderately correlated with related constructs, including opioid dependence (SDS), depression and stress (DASS subscales) and Social Relationships and Environment domains of the WHO-QoL, and had strong face validity among advising clinicians.

CONCLUSIONS: The Opioid-Related Behaviours In Treatment (ORBIT) scale is brief, reliable and validated for use in diverse patient groups receiving opioids. The ORBIT has potential applications as a checklist to prompt clinical discussions and as a tool to quantify aberrant behaviour and assess change over time.

Item Details

Item Type:Refereed Article
Keywords:opioid misuse;
Research Division:Psychology and Cognitive Sciences
Research Group:Other Psychology and Cognitive Sciences
Research Field:Psychology and Cognitive Sciences not elsewhere classified
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Substance Abuse
Author:Bruno, RB (Associate Professor Raimondo Bruno)
ID Code:106558
Year Published:2016
Web of Science® Times Cited:2
Deposited By:Psychology
Deposited On:2016-02-13
Last Modified:2017-11-08
Downloads:0

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