TY - JOUR
T1 - Utility of the Pain Medication Questionnaire to Predict Aberrant Urine Drug Tests
T2 - Results From a Longitudinal Cohort Study
AU - Morasco, Benjamin J.
AU - Iacocca, Megan O.
AU - Lovejoy, Travis I.
AU - Dobscha, Steven K.
AU - Deyo, Richard A.
AU - Cavese, Julie A.
AU - Hyde, Stephanie
AU - Yarborough, Bobbi Jo H.
N1 - Funding Information:
This study was funded in part by Grant 034083 from the National Institute on Drug Abuse of the National Institutes of Health. The work was also supported by resources from the Veterans Affairs Health Services Research and Development–funded Center to Improve Veteran Involvement in Care at the VA Portland Health Care System (CIN 13-404). Funding agencies had no further role in study design; in the collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit for publication. Dr. Yarborough received funding from the Industry Post-Marketing Requirement Consortium, a consortium of 10 companies working to conduct Food and Drug Administration (FDA)- required post-marketing studies that assess risks related to extendedrelease, long-acting opioid analgesics. Richard A. Deyo received royalties from UpToDate for authoring topics on low back pain. His salary at Oregon Health & Science University was supported in part by an endowment from Kaiser Permanente. He received a financial award from NuVasive, as part of a lifetime achievement award from the International Society for Study of the Lumbar Spine. No other author reports having any potential conflict of interest with this study. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the National Institute on Drug Abuse
Publisher Copyright:
© 2021, Psychological Services. All Rights Reserved.
PY - 2021
Y1 - 2021
N2 - Identifying patients at risk of misusing prescription opioids is a priority. Standardized risk measures exist, but prior research has been limited in an assessment of their utility by a reliance on cross-sectional or retrospective analyses. In this study, the Pain Medication Questionnaire (PMQ), a standardized selfreport measure of risk for prescription opioid misuse, was used to predict aberrant urine drug test (UDT) results over the subsequent 24 months. At baseline, participants who were prescribed long-term opioid therapy completed self-report measures assessing pain, function, and quality of life; this also included the PMQ. Medical record data were abstracted for 24 months postbaseline to collect results of UDTs administered during clinical care. Among participants, 12.9% had a UDT result that was positive for a nonprescribed or illicit substance, 18.9% had an aberrant negative UDT result, 3.6% had aberrant positive and negative UDT results, and the remaining 64.6% had expected UDT results. Average PMQ score at baseline did not significantly differ based on participants’ type of UDT result over 24 months of follow-up. Participant variables that were significantly associated with a subsequent aberrant positive UDT were higher prescription opioid dose and hazardous alcohol use; those associated with an aberrant negative UDT were lower prescription opioid dose and hazardous alcohol use; no variable was associated with combined positive and negative UDT results. In conclusion, total PMQ score was not predictive of aberrant positive or negative UDT results. More work is needed to identify optimal strategies of screening for risk of aberrant UDT results
AB - Identifying patients at risk of misusing prescription opioids is a priority. Standardized risk measures exist, but prior research has been limited in an assessment of their utility by a reliance on cross-sectional or retrospective analyses. In this study, the Pain Medication Questionnaire (PMQ), a standardized selfreport measure of risk for prescription opioid misuse, was used to predict aberrant urine drug test (UDT) results over the subsequent 24 months. At baseline, participants who were prescribed long-term opioid therapy completed self-report measures assessing pain, function, and quality of life; this also included the PMQ. Medical record data were abstracted for 24 months postbaseline to collect results of UDTs administered during clinical care. Among participants, 12.9% had a UDT result that was positive for a nonprescribed or illicit substance, 18.9% had an aberrant negative UDT result, 3.6% had aberrant positive and negative UDT results, and the remaining 64.6% had expected UDT results. Average PMQ score at baseline did not significantly differ based on participants’ type of UDT result over 24 months of follow-up. Participant variables that were significantly associated with a subsequent aberrant positive UDT were higher prescription opioid dose and hazardous alcohol use; those associated with an aberrant negative UDT were lower prescription opioid dose and hazardous alcohol use; no variable was associated with combined positive and negative UDT results. In conclusion, total PMQ score was not predictive of aberrant positive or negative UDT results. More work is needed to identify optimal strategies of screening for risk of aberrant UDT results
KW - Long-term opioid therapy
KW - Pain medication questionnaire
KW - Prescription opioid misuse
KW - Urine drug testing
UR - http://www.scopus.com/inward/record.url?scp=85088447802&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088447802&partnerID=8YFLogxK
U2 - 10.1037/ser0000471
DO - 10.1037/ser0000471
M3 - Article
C2 - 32673038
AN - SCOPUS:85088447802
SN - 1541-1559
VL - 18
SP - 319
EP - 327
JO - Psychological Services
JF - Psychological Services
IS - 3
ER -