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

A Peacock; L Degenhardt; Gabrielle Campbell; B Larance; S N Nielsen; W Hall; R P Mattick; R Bruno

doi:10.36076/ppj/2019.19.E421

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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

Peer reviewed

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

A Peacock, L Degenhardt, Gabrielle Campbell, B Larance, S N Nielsen, W Hall, R P Mattick and R Bruno

Pain Physician, Vol.19(3), pp.E421-E434

2016

DOI: https://doi.org/10.36076/ppj/2019.19.E421

PMID: 27008298

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Abstract

Pain

Chronic non-cancer pain

Diversion

Injecting drug use

Non-adherence

Opioid dependence

Pharmaceutical opioids

antidepressant agent

benzodiazepine

buprenorphine

codeine

fentanyl

hydromorphone

methadone

morphine

opiate

oxycodone

tramadol

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.

Details

Title: A typology of predictive risk factors for non-adherent medication-related behaviors among chronic non-cancer pain patients prescribed opioids: A cohort study
Authors: A Peacock (Author) - University of Tasmania
L Degenhardt (Author) - UNSW Australia
Gabrielle Campbell (Author) - UNSW Australia
B Larance (Author) - UNSW Australia
S N Nielsen (Author) - UNSW Australia
W Hall (Author) - The University of Queensland
R P Mattick (Author) - UNSW Australia
R Bruno (Author) - University of Tasmania
Publication details: Pain Physician, Vol.19(3), pp.E421-E434
Publisher: American Society of Interventional Pain Physicians
Date published: 2016
DOI: 10.36076/ppj/2019.19.E421
ISSN: 1533-3159; 1533-3159
PMID: 27008298
Organisation Unit: University of the Sunshine Coast, Queensland; External; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99513874702621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Anesthesiology; Clinical Neurology

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