Assistant Professor, Department of Family and Community Medicine, University of Texas Southwestern, Dallas, Texas.
Research Coordinator, Department of Family and Community Medicine, Saint Louis University School of Medi-cine, St. Louis, Missouri.
J Opioid Manag. 2020 Nov-Dec;16(6):425-434. doi: 10.5055/jom.2020.0600.
Patient beliefs about pain and opioids have been reported from qualitative data. To overcome limitations of unstructured assessments and small sample sizes, we determined if pain and pain medication beliefs varied by chronic pain status and opioid analgesic use (OAU) duration in primary care patients.
Cross-sectional survey data obtained in 2017 and 2018 from 735 patients ≥ 18 years of age. The eight-item Barriers Questionnaire (BQ) measured beliefs about pain and pain medication. Patients reported OAU and use of other pain treatments. Multiple linear regression models estimated the association between never OAU, 1-90 day OAU and >90 day OAU and each BQ item.
Overall, respondents were 49.1 (±15.4) years old, 38.7 percent white, 28.4 percent African-American, 23.5 percent Hispanic, and 68.6 percent female. About one-third never used opioids, 41.8 percent had 1-90 day OAU, and 21.6 percent had > 90 day OAU. Multiple linear regression analyses showed that compared to never OAU, > 90 day OAU had lower average agreement that analgesics are addictive (β = -0.50; 95 percent CI: -0.96, -0.03), and 1-90 day OAU (β = -0.53; 95 percent CI: -0.96, -0.10) and > 90 OAU (β = -0.55; 95 percent CI: -1.04, -0.06) had lower average agreement that analgesics make people do or say embarrassing things.
Patients with chronic OAU reported less concern about addiction and opioid-related behavior change. Never users were most likely to agree that opioids are addictive. There continues to be a need to educate patients about opioid risks. Assessing patients' beliefs may identify patients at risk for chronic OAU.
患者对疼痛和阿片类药物的信念已从定性数据中报道。为了克服非结构化评估和小样本量的限制，我们确定在初级保健患者中，慢性疼痛状况和阿片类药物镇痛使用（OAU）持续时间是否会导致疼痛和疼痛药物信念发生变化。
2017 年和 2018 年从 735 名年龄≥18 岁的患者中获得了横断面调查数据。八项条目的障碍问卷（BQ）测量了对疼痛和疼痛药物的信念。患者报告了 OAU 和其他疼痛治疗的使用情况。多线性回归模型估计了从未使用 OAU、1-90 天 OAU 和>90 天 OAU 与每个 BQ 项目之间的关联。
总体而言，受访者的年龄为 49.1（±15.4）岁，38.7％为白人，28.4％为非裔美国人，23.5％为西班牙裔，68.6％为女性。大约三分之一的人从未使用过阿片类药物，41.8％有 1-90 天的 OAU，21.6％有> 90 天的 OAU。多线性回归分析表明，与从未使用 OAU 相比，> 90 天的 OAU 对阿片类药物具有成瘾性的平均认同度较低（β=-0.50；95％CI：-0.96，-0.03），而 1-90 天的 OAU（β=-0.53；95％CI：-0.96，-0.10）和> 90 OAU（β=-0.55；95％CI：-1.04，-0.06）对阿片类药物使人做出或说出尴尬事情的平均认同度较低。
患有慢性 OAU 的患者报告对成瘾和阿片类药物相关行为改变的担忧较少。从未使用者最有可能同意阿片类药物具有成瘾性。仍然需要对患者进行有关阿片类药物风险的教育。评估患者的信念可能会识别出患有慢性 OAU 风险的患者。
