A typology of predictive risk factors for non-adherent medication-related behaviors among chronic non-cancer pain patients prescribed opioids: a cohort study

Peacock, Amy, Degenhardt, Louisa, Campbell, Gabrielle, Larance, Briony, Nielsen, Suzanne, Hall, Wayne, Mattick, Richard P. and Bruno, Raimondo (2016) A typology of predictive risk factors for non-adherent medication-related behaviors among chronic non-cancer pain patients prescribed opioids: a cohort study. Pain Physician, 19 3: E421-E434.

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Author Peacock, Amy
Degenhardt, Louisa
Campbell, Gabrielle
Larance, Briony
Nielsen, Suzanne
Hall, Wayne
Mattick, Richard P.
Bruno, Raimondo
Title A typology of predictive risk factors for non-adherent medication-related behaviors among chronic non-cancer pain patients prescribed opioids: a cohort study
Journal name Pain Physician   Check publisher's open access policy
ISSN 2150-1149
1533-3159
Publication date 2016-03-01
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 19
Issue 3
Start page E421
End page E434
Total pages 14
Place of publication Paducah, KY, United States
Publisher American Society of Interventional Pain Physicians
Language eng
Subject 2703 Anesthesiology and Pain Medicine
Formatted abstract
Background: There has been no previous prospective examination of the homogeneity of chronic non-cancer pain (CNCP) patients in risk factors for non-adherent opioid use.

Objectives:
To identify whether latent risk classes exist among people with CNCP that predict non-adherence with prescribed opioids.

Study Design: Prospective cohort study.

Methods: The Pain and Opioids IN Treatment prospective cohort comprises 1, 514 people in Australia prescribed pharmaceutical opioids for CNCP interviewed 3 months apart. Risk factors were assessed in wave 1, and non-adherent behaviors in the 3 months prior to wave 1 and wave 2. Latent class analysis was used to examine groups with differing risk profiles. Logistic regression was used to examine predictors of non-adherence.

Results: A 4-class model was selected with classes described as: 1) Poor Physical Functioning group (27%); 2) Poor Coping/Physical Functioning group (35%); 3) Substance Use Problems group (14%); and 4) Multiple Comorbid Problems group (25%). The latter 2 groups had an increased risk of requesting increased opioid doses, early script renewals, using diverted medication, dose stock-piling, and unsanctioned dose alteration at wave 2.

Limitations: Risk factor onset prior to non-adherent behavior cannot be determined.

Conclusions: Clusters of CNCP patients with distinct risk profiles for non-adherence exist. Each group was identified by at least one risk factor but the likelihood of non-adherent opioid use was higher in groups with particular clusters of multiple risk factors. Not all those with risk factors display non-adherence, emphasising the need for strategies to reduce risk for those patients displaying particular clusters of risks.
Keyword Chronic non-cancer pain
Diversion
Injecting drug use
Non-adherence
Non-adherence
Opioid dependence
Pain
Pharmaceutical opioids
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Public Health Publications
 
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