Background

Misuse of prescription opioids, and other drugs prescribed for chronic pain, has increased, with major concerns about harm. This review was undertaken to identify validated measurement tools for risk assessment and monitoring of chronic non-cancer pain patients being considered for, or currently prescribed, analgesic drugs with abuse potential.

Methods

Selected databases (Embase, Medline, Cochrane library/CENTRAL, PsycINFO, PubMed, CINAHL) were systematically searched for studies evaluating tools for risk of analgesic misuse, either before, or during, analgesic therapy for chronic pain, using predetermined inclusion/exclusion criteria. Two independent reviewers assessed abstracts, selected full texts, extracted data and assessed quality.

Results

30 studies from 1844 met inclusion criteria, including three systematic reviews, with an additional four studies from bibliography review. The studies covered 14 tools pertaining to opioid use, with none for non-opioid analgesics.

Although there is no single, clear factor identifying opioid misuse, previous substance misuse appears important. Deception, including lying to clinicians, and using drugs belonging to others are common features. Smoking history may be relevant.

Conclusions

For predicting prescription opioid misuse, the pain medication questionnaire (PMQ) and the screener and opioid assessment for patients with pain (SOAPP) had the best evidence; both developed and validated in five separate studies (four each of acceptable quality). The current opioid misuse measure (COMM) performed best screening for current misuse, developed and validated in three studies of acceptable quality. A small number of tools may accurately predict, or identify, opioid misuse. There are none for non-opioid analgesics, where there is a potential need.

中文翻译：

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系统评价以确定哪些经过验证的测量工具可用于评估慢性疼痛患者使用止痛药的风险

背景

处方阿片类药物和其他用于治疗慢性疼痛的药物的滥用已增加，人们对危害的关注尤为严重。进行该审查以鉴定经验证的测量工具，用于对正在考虑或目前正在开具可能滥用药物的镇痛药的慢性非癌性疼痛患者进行风险评估和监测。

方法

系统地搜索预先选择的数据库（Embase，Medline，Cochrane库/ CENTRAL，PsycINFO，PubMed，CINAHL），以评估使用镇痛药的镇痛药物风险的工具，这些药物使用预定的纳入/排除标准，用于慢性疼痛的镇痛药之前或之中。两名独立的审稿人评估了摘要，选定的全文，提取的数据并评估了质量。

结果

1844年的30项研究符合纳入标准，包括3篇系统综述，另4篇参考书目研究。这项研究涵盖了14种与阿片类药物有关的工具，没有一种用于非阿片类药物的镇痛药。

尽管没有单一明确的因素可以识别阿片类药物滥用，但以前的药物滥用似乎很重要。欺骗，包括对临床医生撒谎，以及使用属于他人的毒品是常见的特征。吸烟史可能是相关的。

结论

为了预测处方阿片类药物的滥用，止痛药物调查表（PMQ）以及对疼痛患者的筛查和阿片类药物评估（SOAPP）是最好的证据。均在五项单独的研究中进行了开发和验证（每项质量均可接受四项）。在目前的阿片类药物滥用的措施（COMM）当前滥用，开发和质量合格的三项研究验证效果最佳检查。少量工具可以准确地预测或识别阿片类药物滥用。对于非阿片类镇痛药，没有潜在的需求。