title: Behavioral, mental, and physical health characteristics and opioid medication misuse among community pharmacy patients: A latent class analysis.
abstract: Community pharmacists are well-positioned to address the US opioid medication crisis, which has created a need to detect misuse risk in order to provide optimal patient care.
  
  
  
  This study sought to identify community pharmacy patient subgroups at risk for opioid medication misuse.
  
  
  
  This study was a cross-sectional survey that examined behavioral, mental, and physical health characteristics among patients filling opioid pain medications. A convenience sample of adult patients filling opioid pain medications who were not receiving cancer treatment were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Patient subgroups were identified using latent class analysis. Latent class regression analysis was used to examine the association between subgroup membership and misuse.
  
  
  
  A total of 333 patients completed the survey (response rate 71.4%). Latent class analysis results showed that a 3-class solution best fit the data, which were labeled: mental health (8.4%, n = 28), poor health (79.6%, n = 265), and hazardous alcohol use (12%, n = 40). Individuals within the mental health subgroup had an increased risk for opioid medication misuse (Odds Ratio = 6.23, 95% CI = 5.13-7.33).
  
  
  
  These findings demonstrate heterogeneity of this population receiving prescribed opioids and the potential to identify subgroups with high misuse risk. These findings also support routine screening of patients filling opioid medications and suggest the need for evidence-based patient-centered intervention development.
authors.affiliation: University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA 15260, USA; University of Pittsburgh, School of Medicine, Department of Psychiatry, 3811 O'Hara St, Pittsburgh, PA 15213, USA. Electronic address: gcochran@pitt.edu.
authors.forename: Gerald
authors.initials: G
authors.lastname: Cochran
authors.affiliation: University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA 15260, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Hruschak
authors.affiliation: University of Washington, School of Pharmacy, Box 357631, H364 Health Sciences Building, Seattle, WA 98195-7631, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bacci
authors.affiliation: University of Tennessee, College of Pharmacy, Department of Clinical Pharmacy, 193 Polk Ave. Suite 2D, Nashville, TN 37210, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Hohmeier
authors.affiliation: University of Pittsburgh, School of Pharmacy, 3501 Terrace St, Pittsburgh, PA 15261, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Tarter
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016017:Odds Ratio; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D010414:Pennsylvania / Q000453:epidemiology; D010594:Pharmacies / Q000706:statistics & numerical data; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid
keywords: Community pharmacy; Latent class analysis; Opioid medication misuse; Screening