From U Pittsburgh: Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic

Am J Hosp Palliat Care. 2014 Apr 16. [Epub ahead of print]

Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic.

Childers JW1, King LA, Arnold RM.

Author information

• 11Department of Medicine, Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, PA, USA.

Abstract

Objectives:To describe the prevalence of chronic pain and the risk of opioid misuse in a palliative care clinic.

METHODS:

We reviewed patient records for 6 months for source of pain, treatment status, opioid misuse risk (Cut down, Annoyed, Guilty, and Eye-opener [CAGE] and Screener and Opioid Assessment for Patients with Pain version 1.0-Short Form [SOAPP-SF] scores), and urine drug screens.

RESULTS:

Of 323 patients, 91% had cancer, 56% undergoing cancer treatment, while 28% had no evidence of disease. Eighty-six (27%) patients had noncancer pain. In all, 46% of new patients had positive scores on the SOAPP-SF and 15% had a positive CAGE. Of the less than 5% of visits that included a urine drug screen, 56% had aberrant results.

Conclusion:Chronic pain and indicators of opioid misuse risk were prevalent. Outpatient palliative care practices should develop policies to address these issues.