Real-Life Testing of the Prescription Opioid Misuse Index in French Primary Care

Int J Environ Res Public Health. 2022 Nov 11;19(22):14845. doi: 10.3390/ijerph192214845.

Abstract

Analgesic opioid (AO) misuse by patients ranges from 0% to 50%. General practitioners are the first prescribers of AO. Our objective was to validate the Prescription Opioid Misuse Index (POMI) in primary care. We conducted a psychometric study in patients with chronic pain who had been taking AOs for at least 3 months and were followed in general practice. Patients responded to the POMI at inclusion and after 2 weeks. The reference used was the DSM-V. Sixty-nine GPs included 160 patients (87 women, 54.4%), mean age 56.4 ± 15.2 years. The total POMI score was 1.50 ± 1.27, and 73/160 (45.6.0%) had a score ≥ 2 (misuse threshold). Internal validity was measured with the Kuder-Richardson coefficient, which was 0.44. Correlations between each item and the total score ranged from 0.06 to 0.35. Test-retest reliability was determined from 145 patients: Lin's concordance coefficient was 0.57 [0.46, 0.68]. Correlation with the DSM-V (Spearman's coefficient) was 0.52. The POMI does not have sufficient psychometric properties to be recommended as a tool to identify the misuse of AOs in primary care. This study clearly showed that there is a need to create a monitoring tool specific to primary care.

Keywords: analgesics; general medicine; misuse; pain; primary care; screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Pain* / drug therapy
  • Female
  • Humans
  • Middle Aged
  • Opioid-Related Disorders* / diagnosis
  • Opioid-Related Disorders* / epidemiology
  • Primary Health Care
  • Psychometrics
  • Reproducibility of Results

Grants and funding

This study was supported by an unrestricted, unsolicited investigator-initiated grant from INDIVIOR, who had no role in study design; collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.