New method helps doctors check pain drug compliance

The Journal of Pain is the peer-review publication of the American Pain Society.

Researchers at Brigham and Women's Hospital developed and validated a brief self-administered compliance checklist for long-term opioid therapy in patients with chronic pain. Currently, there are no widely accepted assessments for monitoring ongoing opioid therapy adherence, and few studies have attempted to link self-report variables with objective evidence of prescription drug misuse.

For the study, a 12-item Opioid Compliance Checklist was repeatedly administered to 157 patients taking opioids for chronic pain who participated in the investigation and were followed for six months.

Results showed that five items best predicted subsequent aberrant drug behaviors. They are:

• Lost or misplaced medications

• Ran out of pain medication early

• Missed scheduled doctor appointments

• Used any illegal or unauthorized substances

• Not been completely honest about personal drug use

Data collected on the sample of patients with chronic pain suggest these five items may be useful in identifying potential for drug misuse and in determining appropriateness of continued treatment.

"We were surprised at how powerfully a brief checklist that reflects how patients comply with parts of an opioid agreement can predict future misuse of opioids," stated lead author, Robert Jamison, PhD, professor, Departments of Anesthesiology and Psychiatry, Brigham and Women's Hospital.