Screening Tools Validated in the Outpatient Pain Management Setting Poorly Predict Opioid Misuse in the Emergency Department: A Pilot Study

Chalmers, Christen E.; Mullinax, Samuel; Brennan, Jesse J.; Vilke, Gary M.; Oliveto, Alison; Wilson, Michael P.

doi:10.1016/j.jemermed.2019.03.018

Cited by 17 publications

(14 citation statements)

References 24 publications

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“…There is evidence that some scoring systems have good sensitivity and specificity for persistent postoperative opioid use [39,40]. Other tools also exist, but their utility in the peri-operative setting is uncertain [41]. A review described the evidence for psychological interventions improving postoperative recovery or reducing persistent postoperative opioid use as weak [42], but this remains a novel area delivering promising results [30,31].…”

Section: Inadequate Patient Assessmentmentioning

confidence: 99%

An international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients

et al. 2020

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Summary This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri‐operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid‐related harm, including persistent postoperative opioid use; opioid‐induced ventilatory impairment; non‐medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre‐operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long‐acting (modified‐release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid‐related harm in adults.

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Section: Inadequate Patient Assessmentmentioning

confidence: 99%

An international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients

et al. 2020

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“…Tool Chalmers et al (2019) examined the use of the COMM and ORT in the ED setting with a consecutive sample of patients experiencing chronic pain. These measures were evaluated for sensitivity and specificity to detect opioid misuse categories (low vs. high risk), and performed poorly when cross-checking with the reference standard-prescription drug monitoring program (PDMP) and electronic health record for aberrant behaviors.…”

Section: Current Opioid Misuse Measure and Opioid Riskmentioning

confidence: 99%

“…One study examined the implementation of the SOAPP-R in the ED setting with a tablet computer, finding screening feasible and generally could be completed in less than 5 min (95%), with 83% of rating the screening as "very easy" (Weiner, Horton, Green, & Butler, 2015). However, the SOAPP-R was less predictive of current opioid misuse/aberrant behaviors when compared with other benchmarks such as the PDMP or the electronic medical record (Chalmers et al, 2019;Weiner, Hoppe, & Finkelman, 2019;Weiner, Horton, Green, & Butler, 2016).…”

Section: Screener and Opioid Assessment For Patients With Painmentioning

confidence: 99%

Opioid-Related Risk Screening Measures for the Emergency Care Setting

Punches

Ali

Brown

et al. 2021

Advanced Emergency Nursing Journal

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Efforts to minimize the impact of prescribed opioids on future adverse outcomes are reliant on emergency care providers' ability to screen and detect opioid use disorder (OUD). Many prescriptions are initiated in the emergency department (ED) for acute pain; thus, validated measures are especially needed. Our systematic review describes the available opioid-related screening measures identified through search of the available literature. Measures were categorized by intent and applied clinical setting. We found 44 articles, identifying 15 screening measures. Of these, nine were developed to screen for current opioid misuse and five to screen for risk of future opioid misuse. None were created for use outside of a chronic pain setting. Many measures were applied differently from intended purpose. Although several measures are available, screening for adverse opioid outcomes in the ED is hampered by lack of validated instruments. Development of clarified conceptual models and ED-specific research is necessary to limit OUD.

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“…24 Providers in the acute care setting are unequipped to assess and differentiate malingering from real pain and pseudo-addiction from real addiction. 16,25 Despite the fact that only 2% of adults with SCD present with true substance dependence, which is at or below the national average, 26 biases still occur. In one study, over 60% of nurses believed that addiction was common among their patients with SCD.…”

Section: Racial Bias Dilutes Accuracy Of Pain Assessmentmentioning

confidence: 99%

If you Can’t Assess It, How Can you Treat It? Improving Pain Management in Sickle Cell Disease

Jonassaint¹

2021

Journal of Emergency Nursing

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Screening Tools Validated in the Outpatient Pain Management Setting Poorly Predict Opioid Misuse in the Emergency Department: A Pilot Study

Cited by 17 publications

References 24 publications

An international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients

An international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients

Opioid-Related Risk Screening Measures for the Emergency Care Setting

If you Can’t Assess It, How Can you Treat It? Improving Pain Management in Sickle Cell Disease

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