Pilot Study of a Preliminary Criterion Standard for Prescription Opioid Misuse

• Published in: The American journal on addictions Vol. 19; no. 6; pp. 523 - 528
• Main Authors: Smith, Robert C., Frank, Cathy, Gardiner, Joseph C., Lamerato, Lois, Rost, Kathryn M.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.11.2010
• Subjects: Addicts; Computerized medical records; Databases, Factual; Experts; Health insurance; Humans; Observer Variation; Opioid-Related Disorders - diagnosis; Opioids; Pilot Projects; Prescription Drugs - adverse effects; Prescription Drugs - standards; Prescriptions
• ISSN: 1055-0496; 1521-0391
• DOI: 10.1111/j.1521-0391.2010.00084.x

Multidisciplinary experts created a behaviorally defined preliminary criterion standard definition of probable prescription opioid misuse (PPOM) that could be rated from material found in administrative, pharmacy, and electronic health record databases. They then derived a scoring system to identify PPOM patients requiring referral to a specialist. Experts next rated cases of misuse and nonmisuse. Rater no. 1 correctly differentiated 37 of 40 cases (92.5%); kappa coefficient was .79 (CI: .57, 1.00). Rater no. 2 correctly identified 39 of 40 cases (97.5%); kappa was .94 (CI: .81, 1.00). Kappa for comparing raters was .73 (CI: .49, .98). This preliminary study demonstrates that multidisciplinary raters can use behaviorally based criteria to identify patients with known PPOM from health plan databases. (Am J Addict 2010;00:1–6)