Negative Affect-Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain.
Identifieur interne : 000011 ( Main/Exploration ); précédent : 000010; suivant : 000012Negative Affect-Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain.
Auteurs : Gadi Gilam [États-Unis] ; John A. Sturgeon [États-Unis] ; Dokyoung S. You [États-Unis] ; Ajay D. Wasan [États-Unis] ; Beth D. Darnall [États-Unis] ; Sean C. Mackey [États-Unis]Source :
- Pain medicine (Malden, Mass.) [ 1526-4637 ] ; 2020.
Abstract
OBJECTIVE
Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors.
METHODS
A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect-related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders.
RESULTS
Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity-worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04).
CONCLUSIONS
Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.
DOI: 10.1093/pm/pnz249
PubMed: 31617916
PubMed Central: PMC7049262
Affiliations:
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Sturgeon</name><affiliation wicri:level="2"><nlm:affiliation>Center for Pain Relief, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Pain Relief, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="You, Dokyoung S" sort="You, Dokyoung S" uniqKey="You D" first="Dokyoung S" last="You">Dokyoung S. You</name><affiliation wicri:level="2"><nlm:affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto</wicri:cityArea></affiliation></author><author><name sortKey="Wasan, Ajay D" sort="Wasan, Ajay D" uniqKey="Wasan A" first="Ajay D" last="Wasan">Ajay D. Wasan</name><affiliation wicri:level="4"><nlm:affiliation>Division of Chronic Pain, Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Chronic Pain, Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region><settlement type="city">Pittsburgh</settlement></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Darnall, Beth D" sort="Darnall, Beth D" uniqKey="Darnall B" first="Beth D" last="Darnall">Beth D. Darnall</name><affiliation wicri:level="2"><nlm:affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto</wicri:cityArea></affiliation></author><author><name sortKey="Mackey, Sean C" sort="Mackey, Sean C" uniqKey="Mackey S" first="Sean C" last="Mackey">Sean C. Mackey</name><affiliation wicri:level="2"><nlm:affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto</wicri:cityArea></affiliation></author></analytic><series><title level="j">Pain medicine (Malden, Mass.)</title><idno type="eISSN">1526-4637</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect-related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity-worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">31617916</PMID><DateRevised><Year>2020</Year><Month>04</Month><Day>14</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1526-4637</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>02</Month><Day>01</Day></PubDate></JournalIssue><Title>Pain medicine (Malden, Mass.)</Title></Journal><ArticleTitle>Negative Affect-Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain.</ArticleTitle><Pagination><MedlinePgn>e127-e138</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/pm/pnz249</ELocationID><Abstract><AbstractText Label="OBJECTIVE">Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors.</AbstractText><AbstractText Label="METHODS">A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect-related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders.</AbstractText><AbstractText Label="RESULTS">Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity-worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04).</AbstractText><AbstractText Label="CONCLUSIONS">Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.</AbstractText><CopyrightInformation>© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gilam</LastName><ForeName>Gadi</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sturgeon</LastName><ForeName>John A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Center for Pain Relief, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>You</LastName><ForeName>Dokyoung S</ForeName><Initials>DS</Initials><AffiliationInfo><Affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wasan</LastName><ForeName>Ajay D</ForeName><Initials>AD</Initials><AffiliationInfo><Affiliation>Division of Chronic Pain, Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Darnall</LastName><ForeName>Beth D</ForeName><Initials>BD</Initials><AffiliationInfo><Affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mackey</LastName><ForeName>Sean C</ForeName><Initials>SC</Initials><AffiliationInfo><Affiliation>Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K24 DA029262</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 DA035484</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Pain Med</MedlineTA><NlmUniqueID>100894201</NlmUniqueID><ISSNLinking>1526-2375</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Anger</Keyword><Keyword MajorTopicYN="Y">Anxiety</Keyword><Keyword MajorTopicYN="Y">CHOIR</Keyword><Keyword MajorTopicYN="Y">Chronic Pain</Keyword><Keyword MajorTopicYN="Y">Depression</Keyword><Keyword MajorTopicYN="Y">Prescribed Opioids Misuse</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pmc-release"><Year>2021</Year><Month>02</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>10</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>10</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>10</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31617916</ArticleId><ArticleId IdType="pii">5588606</ArticleId><ArticleId IdType="doi">10.1093/pm/pnz249</ArticleId><ArticleId 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name="États-Unis"><region name="Californie"><name sortKey="Gilam, Gadi" sort="Gilam, Gadi" uniqKey="Gilam G" first="Gadi" last="Gilam">Gadi Gilam</name></region><name sortKey="Darnall, Beth D" sort="Darnall, Beth D" uniqKey="Darnall B" first="Beth D" last="Darnall">Beth D. Darnall</name><name sortKey="Mackey, Sean C" sort="Mackey, Sean C" uniqKey="Mackey S" first="Sean C" last="Mackey">Sean C. Mackey</name><name sortKey="Sturgeon, John A" sort="Sturgeon, John A" uniqKey="Sturgeon J" first="John A" last="Sturgeon">John A. Sturgeon</name><name sortKey="Wasan, Ajay D" sort="Wasan, Ajay D" uniqKey="Wasan A" first="Ajay D" last="Wasan">Ajay D. Wasan</name><name sortKey="You, Dokyoung S" sort="You, Dokyoung S" uniqKey="You D" first="Dokyoung S" last="You">Dokyoung S. You</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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