Jones Ted, Passik Steven D
Behavioral Medicine Institute at Pain Consultants of East Tennessee, Knoxville, Tennessee, USA.
J Opioid Manag. 2011 Sep-Oct;7(5):347-51. doi: 10.5055/jom.2011.0075.
Risk assessment and stratification have become important aspects for the prescription of opioids to patients with chronic pain. Recent research has shown that the Opioid Risk Tool (ORT), a widely used risk assessment tool, has poor predictive abilities when compared with other risk assessment methods. This study compares two different methods of administration of the ORT to further study this issue. Patients at a pain practice were given an ORT to complete per the usual method of administration. In addition, a separate blinded ORT was completed by a psychologist after conducting a clinical interview with the patient. The results of the patient-completed ORT (PC-ORT) and the clinician-completed ORT (CC-ORT) were compared. There were significant differences found between the two, with the psychologist usually rating the patient higher in risk. The CC-ORT demonstrated better prediction of aberrant drug-taking behavior than the PC-ORT. The items that were discrepant between the two suggest that the differences were primarily due to comprehension issues. A strategy to help maximize the usefulness of the ORT derived from this finding and clinical experience is discussed.
风险评估与分层已成为慢性疼痛患者阿片类药物处方的重要方面。最近的研究表明，与其他风险评估方法相比，广泛使用的风险评估工具阿片类药物风险评估表（ORT）的预测能力较差。本研究比较了ORT的两种不同施测方法，以进一步研究此问题。疼痛科的患者按照常规施测方法完成一份ORT。此外，心理学家在对患者进行临床访谈后，独立完成一份盲法ORT。比较了患者完成的ORT（PC-ORT）和临床医生完成的ORT（CC-ORT）的结果。发现两者之间存在显著差异，心理学家通常对患者的风险评级更高。CC-ORT在异常药物使用行为预测方面比PC-ORT表现更好。两者之间存在差异的项目表明，差异主要是由于理解问题。本文讨论了基于这一发现和临床经验来帮助最大化ORT效用的策略。
