Opioid Safety Assessment Implementation in Palliative Care Clinic (S799)

Assessment tools for problematic opioid use in palliative care: A scoping review

“…The grey literature search did not yield any results that met our study eligibility criteria. We contacted authors of 13 studies [53][54][55][56][57][58][59][68][69][70][71][72][73] and received responses from six authors, 54,55,[69][70][71][72] who provided additional data for four studies. 54,55,69,72 We identified two types of tools used to assess for problematic opioid use in palliative care: questionnaires (n = 32, 76%) [53][54][55]57,58,[61][62][63]65,66, and urine drug tests (n = 21, 50%), 17,53,55,56,57,59,60,63,64,67,68,70,71,81,82,85,…”

“…We identified two types of tools used to assess for problematic opioid use in palliative care: questionnaires ( n = 32, 76%) 53–55,57,58,61–63,65,66,68–89 and urine drug tests ( n = 21, 50%), 17,53,55,56,57,59,60,63,64,67,68,70,71,81,82,85,89–93 with an overlap of both types in 11 studies (26%). 53,55,57,63,68,70,71,81,82,85,89 Two studies did not specify which questionnaire they used. 68,8...…”

“…Most studies ( n = 30, 94%) were conducted in outpatient clinics 53–55,57,58,61–63,65,66,68–79,81–83,85–89 and in the US ( n = 28, 88%), 53–55,57,58,61,62,63,65,66,69–79,81–83,85–87,89 and published between 2009 and 2020. The same tertiary cancer center conducted many of the studies ( n = 16, 50%): CAGE ( n = 7, 44%), 74–80 CAGE-AID ( n = 6, 37.5%), 62,81…”

“…90 The most common study design was crosssectional (n = 13, 62%) (Table 2). 53,[55][56][57]59,60,63,64,68,70,71,85,91 The reported primary study objectives were: to identify factors associated with ordering urine drug tests; 82 to report on the use of urine drug tests; 17,53,55,57,59,64,67,68,71,85,90,92,93 and to correlate abnormal urine drug tests with patient characteristics, including age, 64,70,89 gender, 64,60 marital status, 64 cancer diagnosis, 70 type of pain, 70 symptoms (e.g. anxiety, appetite), 60 treatment status (active or palliative), 70 and problematic opioids risk tools (ORT, 85 SOAPP-SF 63 ) (Table 2).…”

“…59,63,70,82,91,93 Two studies (10%) conducted in the same supportive care clinic first performed immunoassays and then confirmed the results with GC-MS. 82,91 The other four studies (19%) reported use of only GC-MS. 59,70,93 The urine drug test type used in the remaining 15 studies (71%) was not reported. 17,53,[55][56][57]60,64,67,68,71,81,85,89,90,92 The 21 studies varied in terms of how they incorporated urine drug tests into clinical care (Table 4). Six studies (29%) routinely used urine drug tests in clinical care: four studies ordered urine drug tests for all clinic patients; 55,56,63,64 , and, the two other studies ordered urine drug tests for all patients being considered for chronic opioid therapy.…”