Validation of the Revised Screener and Opioid Assessment for Patients With Pain (SOAPP-R)

Abstract

The original Screener and Opioid Assessment for Patients with Pain (SOAPP) is a conceptually derived self-report questionnaire designed to predict aberrant medication-related behaviors among chronic pain patients considered for long-term opioid therapy. The purpose of this study was to develop and validate an empirically-derived version of the SOAPP (SOAPP-R) that addresses some limitations of the original SOAPP. In successive steps, items were reduced from an initial pool of 142 to a 97-item beta version. The beta version was administered to 283 chronic pain patients on long-term opioid therapy. Items were evaluated based on data collected at follow-up, including correlation with the Aberrant Drug Behavior Index (ADBI), derived from interview data, physician ratings, and urine toxicology screens. Twenty-four items were retained and comprise the final SOAPP-R. Coefficient α was .88, and receiver operating characteristics (ROC) curve analysis yielded an area under the curve (AUC) of .81 (p < .001). A cutoff score of 18 showed adequate sensitivity (.81) and specificity (.68). The obtained psychometrics, along with the use of a predictive criterion that goes beyond self-report, suggest that the SOAPP-R is an improvement over the original version in screening risk potential for aberrant medication-related behavior among persons with chronic pain. Perspective:There is need for a screener for abuse risk in patients prescribed opioids for pain. This study presents a revised version of the Screener and Opioid Assessment for Patients with Pain (SOAPP-R) that is empirically-derived with good reliability and validity, but is less susceptible to overt deception then the original SOAPP v.1.

Predicting Risk for Opioid Misuse in Chronic Pain with a Single-Item Measure of Catastrophic Thinking

“…9 The SOAPP-R demonstrates good internal consistency, specificity, and sensitivity in identifying individuals with elevated risk for medication misuse. 9 Scores of 22 or greater suggest high risk for opioid medication misuse.…”

Risk Factors in Opioid Treatment of Chronic Non-Cancer Pain: A Multidisciplinary Assessment

“…Moore et al (2009), in a study to examine the efficacy of the SOAPP and other tools in predicting the risk of opioid misuse, found good sensitivity for the tool (0.72); combining the data from the SOAPP with those from a semi-structured clinical interview designed to investigate prior treatments used, the presence of emotional distress and prior substance abuse, the sensitivity increased to 0.90. e2. The Screener and Opioid Assessment for Patients with Pain -Revised (SOAPP-R) is a 24-item version developed by Butler et al (2008) in order to overcome some limitations of the original SOAPP. The new version, tested on a sample of 283 patients, proved to have good internal consistency (Cronbach's α = 0.88); the cut-off of 18 shows adequate sensitivity (0.81) and specificity (0.68).…”

Strategies to Reduce the Tampering and Subsequent Abuse of Long-acting Opioids: Potential Risks and Benefits of Formulations With Physical or Pharmacologic Deterrents to Tampering

“…3 Validated screening tools, such as the revised Screener and Opioid Assessment for Patients with Pain, 17 Current Opioid Misuse Measure, 18 and the Opioid Risk Tool, 19 should be applied to formally assess the risk of aberrant drug-taking behavior and potential for opioid abuse. Initiation of longterm opioid therapy should also include the use of a written compliance agreement, which may include a review of potential risks, benefits, and harms of opi-…”