Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for Assessing Adherence to the Centers for Disease Control Opioid Prescribing Guidelines

Abstract

Objective In response to the opioid epidemic, the Centers for Disease Control and Prevention issued guidelines (CDCG) in 2016 for the prescription of opioids for chronic pain. To facilitate research into whether CDCG implementation will lead to reductions in opioid prescribing and improved patient safety, we sought to validate a tool that quantifies CDCG adherence based on clinical documentation. Design The Safe Opioid Prescribing Evaluation Tool (SOPET) was developed in four phases as part of a study to improve the implementation of the CDCG in the clinical setting. Four raters with varying levels of clinical experience and expertise were trained to use the SOPET and then used it to evaluate 21 baseline patient encounters. Intraclass correlation coefficient (ICC) estimates and their 95% confident intervals (CIs) were calculated for the total SOPET score based on a mean-rating (k = 4), absolute-agreement, two-way random-effects model. For intrarater reliability, two-way mixed-effect models were used. Results Inter-rater reliability was good, with an average-measures ICC of 0.82 (95% CI = 0.63–0.92). Intrarater reliability was excellent for the three raters, who were MDs, with average-measures ICCs as follows: 0.92 (95% CI = 0.81–0.97), 0.97 (95% CI = 0.92–0.99), 0.99 (95% CI = 0.99–0.99). However, the intrarater reliability for the non-MD rater was lower 0.69 (95% CI = 0.22–0.88). Conclusions Overall, the SOPET is useful for evaluating implementation of the CDCG in clinical documentation. It is an important first step in the design of future studies assessing whether adherence to the CDCG improves patient safety outcomes.

Toward Safer Opioid Prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial

“…A validated method to quantify adherence to an opioid prescribing guideline in its entirety (rather than individual components such as MME or the use of urine drug testing (UDT)) did not previously exist and so we developed, validated and published the Safer Opioid Prescribing Evaluation Tool (SOPET) as our primary outcome measure [ 24 ]. The SOPET is used to score clinical documentation for CDC Guideline adherence, and produces a score from 0 to 15, where 15 indicates perfect adherence.…”