Jamison Robert N, Link Carol L, Marceau Lisa D
Pain Management Center, Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02467, USA.
Pain Med. 2009 Sep;10(6):1084-94. doi: 10.1111/j.1526-4637.2009.00679.x. Epub 2009 Aug 7.
The Screener and Opioid Assessment of Pain Patients (SOAPP v.1) has been shown to be a reliable measure of risk potential for substance misuse and to correlate with a history of substance abuse, legal problems, craving, smoking, and mood disorders among chronic pain patients. The aim of this study was to examine differences over time on a number of measures among chronic pain patients who were classified as high or low risk for opioid misuse based on scores on the SOAPP.
From an initial sample of one hundred thirty-four participants (N = 134), one hundred and ten (N = 110) completed the SOAPP and were grouped as high or low risk for misuse of medication based on SOAPP scores of > or =7. All subjects were asked to complete baseline measures and in-clinic monthly diaries of their pain, mood, activity interference, medication, and side effects over a 10-month study period.
The results showed that although those who were classified as high-risk for opioid misuse reported significantly higher levels of pain intensity, activity interference, pain catastrophizing, disability, and depressed mood at baseline (P < 0.05), only pain intensity ratings were found to differentiate groups over time (P < 0.01). These results were unrelated to perceived helpfulness of pain treatment.
Differences in subjective pain intensity were found between those who are high risk for opioid misuse compared with those at low risk for medication misuse, implying that higher-risk patients may experience more subjective pain. Consequently, these patients may be more challenging to treat.
疼痛患者筛选与阿片类药物评估工具（SOAPP v.1）已被证明是一种可靠的药物滥用风险潜力测量工具，并且与慢性疼痛患者的药物滥用史、法律问题、渴望、吸烟及情绪障碍相关。本研究的目的是基于SOAPP评分，检查被归类为阿片类药物滥用高风险或低风险的慢性疼痛患者在一段时间内多项指标的差异。
从134名参与者的初始样本中，110人完成了SOAPP，并根据SOAPP评分≥7被分为药物滥用高风险或低风险组。在为期10个月的研究期间，所有受试者被要求完成基线测量以及关于疼痛、情绪、活动干扰、药物和副作用的门诊月度日记。
结果显示，尽管被归类为阿片类药物滥用高风险的患者在基线时报告的疼痛强度、活动干扰、疼痛灾难化、残疾和抑郁情绪水平显著更高（P<0.05），但仅疼痛强度评分在一段时间内能够区分两组（P<0.01）。这些结果与疼痛治疗的感知帮助无关。
与药物滥用低风险患者相比，阿片类药物滥用高风险患者的主观疼痛强度存在差异，这意味着高风险患者可能经历更多的主观疼痛。因此，这些患者可能更具治疗挑战性。
