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Utility of the Pain Medication Questionnaire to predict aberrant urine drug tests: Results from a longitudinal cohort study.
Psychological Services ( IF 1.9 ) Pub Date : 2020-07-16 , DOI: 10.1037/ser0000471
Benjamin J Morasco 1 , Megan O Iacocca 1 , Travis I Lovejoy 1 , Steven K Dobscha 1 , Richard A Deyo 2 , Julie A Cavese 3 , Stephanie Hyde 1 , Bobbi Jo H Yarborough 3
Affiliation  

Identifying patients at risk of misusing prescription opioids is a priority. Standardized risk measures exist, but prior research has been limited in an assessment of their utility by a reliance on cross-sectional or retrospective analyses. In this study, the Pain Medication Questionnaire (PMQ), a standardized self-report measure of risk for prescription opioid misuse, was used to predict aberrant urine drug test (UDT) results over the subsequent 24 months. At baseline, participants who were prescribed long-term opioid therapy completed self-report measures assessing pain, function, and quality of life; this also included the PMQ. Medical record data were abstracted for 24 months postbaseline to collect results of UDTs administered during clinical care. Among participants, 12.9% had a UDT result that was positive for a nonprescribed or illicit substance, 18.9% had an aberrant negative UDT result, 3.6% had aberrant positive and negative UDT results, and the remaining 64.6% had expected UDT results. Average PMQ score at baseline did not significantly differ based on participants' type of UDT result over 24 months of follow-up. Participant variables that were significantly associated with a subsequent aberrant positive UDT were higher prescription opioid dose and hazardous alcohol use; those associated with an aberrant negative UDT were lower prescription opioid dose and hazardous alcohol use; no variable was associated with combined positive and negative UDT results. In conclusion, total PMQ score was not predictive of aberrant positive or negative UDT results. More work is needed to identify optimal strategies of screening for risk of aberrant UDT results. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译:

止痛药问卷预测异常尿液药物测试的效用:纵向队列研究的结果。

识别有滥用处方阿片类药物风险的患者是当务之急。存在标准化的风险度量,但先前的研究由于依赖于横断面或回顾性分析而在评估其效用方面受到限制。在这项研究中,疼痛药物问卷 (PMQ) 是一种标准化的自我报告处方阿片类药物滥用风险的衡量标准,用于预测随后 24 个月的异常尿液药物测试 (UDT) 结果。在基线时,接受长期阿片类药物治疗的参与者完成了评估疼痛、功能和生活质量的自我报告措施;这也包括 PMQ。提取基线后 24 个月的医疗记录数据,以收集临床护理期间施用的 UDT 结果。在参与者中,12。9% 的 UDT 结果为非处方药或非法物质阳性,18.9% 的 UDT 结果异常阴性,3.6% 的 UDT 结果异常阳性和阴性,其余 64.6% 的 UDT 结果为预期。根据参与者在 24 个月随访期间的 UDT 结果类型,基线时的平均 PMQ 得分没有显着差异。与随后的异常阳性 UDT 显着相关的参与者变量是较高的阿片类药物处方剂量和危险的酒精使用;与异常阴性 UDT 相关的是较低的阿片类药物处方剂量和危险的酒精使用;没有变量与联合阳性和阴性 UDT 结果相关。总之,PMQ 总分不能预测异常的阳性或阴性 UDT 结果。需要做更多的工作来确定筛查异常 UDT 结果风险的最佳策略。(PsycInfo 数据库记录 (c) 2020 APA,保留所有权利)。
更新日期:2020-07-16
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