Jones Ted, Lookatch Samantha, Moore Todd
Pain Consultants of East Tennessee, Behavioral Medicine Institute, Knoxville, Tennessee.
Department of Psychology, University of Tennessee Knoxville, Knoxville, Tennessee.
J Opioid Manag. 2015 Mar-Apr;11(2):171-83. doi: 10.5055/jom.2015.0266.
Opioids remain a common method of treating chronic pain conditions despite some controversy. In an effort to address some of the risks of opioid medications, opioid risk assessment has become a standard of care when opioids are used to treat a chronic pain condition. Research to date has found that many currently available patient-completed written questionnaires are relatively poor at identifying which patients will engage in medication aberrant behavior in the future. Clinical interview techniques have been found to provide better prediction, but practitioners often prefer the convenience of patient-completed tools. In this study, a new brief patient-completed risk tool, the Brief Risk Questionnaire (BRQ), was created and compared with a structured clinical interview and two commonly used patient-completed risk assessment tools: the Opioid Risk Tool (ORT) and Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R). The different risk assessment measures were administered to 454 patients at a pain clinic and their prediction of medication aberrant behavior at 6-month follow-up was compared. Results found that the BRQ was able to predict future medication aberrant behavior better than the other two patient-completed risk measures and almost as well overall as a structured clinical interview rating system. This study indicates that the BRQ could be a useful new tool for clinicians in conducting opioid risk assessment.
尽管存在一些争议，但阿片类药物仍然是治疗慢性疼痛病症的常用方法。为了应对阿片类药物治疗的某些风险，在使用阿片类药物治疗慢性疼痛病症时，阿片类药物风险评估已成为一种标准治疗手段。迄今为止的研究发现，许多目前可供患者填写的书面问卷在识别哪些患者将来会出现药物异常行为方面表现相对较差。已发现临床访谈技术能提供更好的预测，但从业者通常更喜欢患者填写工具的便利性。在本研究中，创建了一种新的简短患者填写风险工具——简短风险问卷（BRQ），并将其与结构化临床访谈以及两种常用的患者填写风险评估工具进行比较：阿片类药物风险工具（ORT）和疼痛患者筛查与阿片类药物评估修订版（SOAPP-R）。对一家疼痛诊所的454名患者进行了不同的风险评估措施，并比较了它们对6个月随访时药物异常行为的预测。结果发现，BRQ在预测未来药物异常行为方面比其他两种患者填写的风险评估措施更好，总体上几乎与结构化临床访谈评分系统一样好。这项研究表明，BRQ可能是临床医生进行阿片类药物风险评估的一种有用的新工具。
