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A Typology of Predictive Risk Factors for Non-Adherent Medication-Related Behaviors among Chronic Non-Cancer Pain Patients Prescribed Opioids: A Cohort Study

Journal Article


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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.

Authors


  •   Peacock, Amy (external author)
  •   Degenhardt, Louisa (external author)
  •   Campbell, Gabrielle (external author)
  •   Larance, Briony
  •   Nielsen, Suzanne (external author)
  •   Hall, Wayne (external author)
  •   Mattick, Richard P. (external author)
  •   Bruno, Raimondo (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Degenhardt, L., Campbell, G., Larance, B., Nielsen, S., Hall, W., Mattick, R. P. & Bruno, R. (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.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5204&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4179

Start Page


  • E421

End Page


  • E434

Volume


  • 19

Issue


  • 3

Place Of Publication


  • United States

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.

Authors


  •   Peacock, Amy (external author)
  •   Degenhardt, Louisa (external author)
  •   Campbell, Gabrielle (external author)
  •   Larance, Briony
  •   Nielsen, Suzanne (external author)
  •   Hall, Wayne (external author)
  •   Mattick, Richard P. (external author)
  •   Bruno, Raimondo (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Degenhardt, L., Campbell, G., Larance, B., Nielsen, S., Hall, W., Mattick, R. P. & Bruno, R. (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.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5204&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4179

Start Page


  • E421

End Page


  • E434

Volume


  • 19

Issue


  • 3

Place Of Publication


  • United States