Cross validation of the current opioid misuse measure to monitor chronic pain patients on opioid therapy.
OBJECTIVE
The Current Opioid Misuse Measure (COMM) is a self-report measure of risk for aberrant medication-related behavior among persons with chronic pain who are prescribed opioids for pain. It was developed to complement predictive screeners of opioid misuse potential and improve a clinician's ability to periodically assess a patient's risk for opioid misuse. The aim of this study was to cross-validate the COMM with a sample of chronic noncancer pain patients.


METHODS
Two hundred and twenty-six participants prescribed opioids for pain were recruited from 5 pain management centers in the United States. Participants completed the 17-item COMM and a series of self-report measures. Patients were rated by their treating physician, had a urine toxicology screen, and were classified on the Aberrant Drug Behavior index.


RESULTS
The reliability and predictive validity in this cross validation as measured by the area under the curve (AUC) were found to be highly significant (AUC=0.79) and not significantly different from the AUC obtained in the original validation study (AUC=0.81). Reliability (coefficient α) was 0.83, which is comparable to the 0.86 obtained in the original sample.


CONCLUSIONS
Results of the cross validation suggest that the psychometric parameters of the COMM are not based solely on unique characteristics of the initial validation sample. The COMM seems to be a reliable and valid screening tool to help detect current aberrant drug-related behavior among chronic pain patients.
Butler
Stephen F
SF
Inflexxion, Inc., Newton.
Budman
Simon H
SH
Fanciullo
Gilbert J
GJ
Jamison
Robert N
RN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D019540:Area Under Curve; D002908:Chronic Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis* / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011594:Psychometrics; D012372:ROC Curve; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States; D016482:Urinalysis
D000701:Analgesics, Opioid