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计算机管理的常规阿片类药物结果监测(ROOM)工具的有效性和可靠性

Validity and Reliability of the Computer-Administered Routine Opioid Outcome Monitoring (ROOM) Tool.

作者信息

Picco Louisa, Middleton Melissa, Bruno Raimondo, Kowalski Michala, Nielsen Suzanne

机构信息

Monash Addiction Research Centre, Monash University Peninsula Campus, Frankston, Victoria, Australia.

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.

出版信息

Pain Med. 2020 Dec 25;21(12):3645-3654. doi: 10.1093/pm/pnaa297.

Abstract

OBJECTIVE

The Routine Opioid Outcome Monitoring (ROOM) tool measures outcomes with opioids using an established framework which includes domains such as pain, mood, opioid use disorder, alcohol use, and constipation. This study aims to validate and establish the test-retest reliability of the computer-administered ROOM tool.

DESIGN AND SETTING

Cross-sectional analysis of an online sample.

SUBJECTS

Participants comprised those with chronic noncancer pain who regularly used prescription opioids.

METHODS

Participants self-completed the online ROOM tool along with other validated measures (validation questionnaire), and those who were agreeable also completed the online test-retest questionnaire approximately two weeks later. Subcomponents of the ROOM tool (i.e., pain, mood, alcohol use, opioid use disorder, and constipation) were validated against longer measures of the same construct using Pearson correlation coefficients. Intraclass correlation coefficients were used to assess the stability of the ROOM tool over time.

RESULTS

A total of 324 participants completed the validation questionnaire, of whom 260 also completed the test-retest questionnaire. The opioid use disorder domain showed good sensitivity (73.6) and specificity (75.8) against the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, any opioid use disorder. All ROOM components showed moderate correlation (r = 0.55-0.73) with their longer counterparts. Test-retest reliability was fair (0.58-0.75), indicating that responses were relatively stable over time. Reliability did vary, however, based on the components being measured and how certain tools were scored.

CONCLUSION

The computer-administered ROOM tool is a valid approach for brief monitoring of outcomes with prescribed opioids in primary care settings and appears to be acceptable to people who are using prescribed opioids for chronic pain.

摘要

目的

常规阿片类药物结果监测(ROOM)工具使用既定框架来衡量阿片类药物的结果,该框架包括疼痛、情绪、阿片类药物使用障碍、酒精使用和便秘等领域。本研究旨在验证并确定计算机管理的ROOM工具的重测信度。

设计与设置

对在线样本进行横断面分析。

研究对象

参与者包括经常使用处方阿片类药物的慢性非癌性疼痛患者。

方法

参与者自行完成在线ROOM工具以及其他经过验证的测量工具(验证问卷),同意参与的人还会在大约两周后完成在线重测问卷。使用Pearson相关系数,将ROOM工具的子组件(即疼痛、情绪、酒精使用、阿片类药物使用障碍和便秘)与同一结构的更长测量工具进行对照验证。使用组内相关系数来评估ROOM工具随时间的稳定性。

结果

共有324名参与者完成了验证问卷,其中260人还完成了重测问卷。阿片类药物使用障碍领域对《精神疾病诊断与统计手册》第5版中任何阿片类药物使用障碍的敏感性良好(73.6),特异性良好(75.8)。所有ROOM组件与其更长的对应组件显示出中度相关性(r = 0.55 - 0.73)。重测信度一般(0.58 - 0.75),表明随着时间的推移,回答相对稳定。然而,信度确实因所测量的组件以及某些工具的评分方式而有所不同。

结论

计算机管理的ROOM工具是在初级保健环境中对处方阿片类药物结果进行简短监测的有效方法,并且似乎为使用处方阿片类药物治疗慢性疼痛的人所接受。

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