Peacock, A and Degenhardt, L and Campbell, G and Larance, B and Nielsen, S and Hall, W and Mattick, RP and Bruno, R, A typology of predictive risk factors for non-adherent medication-related behaviors among chronic non-cancer pain patients prescribed opioids: a cohort study, Pain Physician, 19, (3) pp. E421-E434. ISSN 1533-3159 (2016) [Refereed Article]
Copyright 2016 Association of Pain Management Anesthesiologists
Official URL: http://www.painphysicianjournal.com/current/abstra...
Background: There has been no previous prospective examination of the homogeneity of chronic non-cancer pain (CNCP) patients in risk factors for non-adherent opioid use.
Objectives: To identify whether latent risk classes exist among people with CNCP that predict non-adherence with prescribed opioids.
Study Design: Prospective cohort study.
Methods: The Pain and Opioids IN Treatment prospective cohort comprises 1,514 people in Australia prescribed pharmaceutical opioids for CNCP interviewed 3 months apart. Risk factors were assessed in wave 1, and non-adherent behaviors in the 3 months prior to wave 1 and wave 2. Latent class analysis was used to examine groups with differing risk profiles. Logistic regression was used to examine predictors of non-adherence.
Results: A 4-class model was selected with classes described as: 1) Poor Physical Functioning group (27%); 2) Poor Coping/Physical Functioning group (35%); 3) Substance Use Problems group (14%); and 4) Multiple Comorbid Problems group (25%). The latter 2 groups had an increased risk of requesting increased opioid doses, early script renewals, using diverted medication, dose stock-piling, and unsanctioned dose alteration at wave 2.
Limitations: Risk factor onset prior to non-adherent behavior cannot be determined.
Conclusions: Clusters of CNCP patients with distinct risk profiles for non-adherence exist. Each group was identified by at least one risk factor but the likelihood of non-adherent opioid use was higher in groups with particular clusters of multiple risk factors. Not all those with risk factors display non-adherence, emphasising the need for strategies to reduce risk for those patients displaying particular clusters of risks.
|Item Type:||Refereed Article|
|Keywords:||opioid treatment, pharmaceutical opioids, non-adherence, injecting drug use, opioid dependence, chronic non-cancer pain, non-adherence, diversion|
|Research Division:||Psychology and Cognitive Sciences|
|Research Group:||Other Psychology and Cognitive Sciences|
|Research Field:||Psychology and Cognitive Sciences not elsewhere classified|
|Objective Group:||Public Health (excl. Specific Population Health)|
|Objective Field:||Substance Abuse|
|Author:||Peacock, A (Miss Amy Peacock)|
|Author:||Bruno, R (Associate Professor Raimondo Bruno)|
|Funding Support:||National Health and Medical Research Council (APP1022522)|
|Downloads:||14 View Download Statistics|
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