A comparison of an opioid abuse screening tool and prescription drug monitoring data in the emergency department

Based on a recent study, our team has published an article in the “Drug and Alcohol Dependence” journal titled, “A comparison of an opioid abuse screening tool and prescription drug monitoring data in the emergency department.”  Highlights from the study findings concluded that:

• It can be difficult to detect substance use disorders in emergency department patients.
• This study compared scores on the SOAPP-R screening tool with PDMP data.
• The sensitivity of SOAPP-R for detecting high-risk PDMP criteria was low (54%).
• Negative predictive value was high, so it may be a useful screening tool in the ED.

For more information about this study, please see the abstract below.  To obtain the full article, click here.

Objectives
This study aimed to: (a) determine the percentage of ED patients receiving prescriptions for opioid pain medications that meet the criteria for “high-risk for abuse potential” on the Screener and Opioid Assessment for Patients with Pain (SOAPP®-R), (b) determine the percentage of patients with high-risk behavior on the state prescription drug monitoring program (PDMP) database, (c) compare the SOAPP-R with data from the PDMP, and (d) determine psychometric properties of SOAPP-R for ED patients.

Methods
Convenience sample of ED patients who were being considered for discharge with a prescription for an opioid pain medication. Subjects completed SOAPP-R on an electronic tablet and PDMP data was obtained. Scores on SOAPP-R ≥18 were defined as “at-risk”, and PDMP data showing both ≥4 opioid prescriptions and ≥4 providers in 12 months was considered the criterion standard for high-risk behavior.

Results
82 patients (88.2%) provided consent. 32.9% (n = 27) were determined to be “at-risk” (score ≥18) by SOAPP-R. 15.9% (n = 13) subjects met PDMP criteria and 53.9% (n = 7) of those had SOAPP-R scores ≥18 (sensitivity 54%, specificity 71%, positive predictive value 26%, negative predictive value 89%). The association of an at-risk SOAPP-R score and PDMP high-risk criteria was an adjusted odds ratio of 1.39 (95% confidence interval 0.73–3.68).

Conclusions
In our population, about one-third of patients being considered for discharge with an opioid prescription scored “at-risk” on SOAPP-R and 15.9% met the PDMP high-risk criteria. The high negative predictive value of SOAPP-R indicates it may be a useful screening tool for the ED patient population.

To obtain the full article, click here.