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

• Published in: International journal of environmental research and public health 2022-11, Vol.19 (22), p.14845
• Main Authors: Laporte, Catherine, Fortin, Frédéric, Dupouy, Julie, Quirin, Aurélie, Pereira, Bruno, Chenaf, Chouki, Delorme, Jessica, Maynié-François, Christine, Rat, Cédric, Birebent, Jordan, Rambaud, Jacques, Duale, Christian, Kerckhove, Nicolas, Delage, Noémie, Authier, Nicolas
• Format: Article
• Language: English
• Subjects: Addictions; Adult; Aged; Analgesics; Chronic Pain; Chronic Pain - drug therapy; Clinics; Coefficients; Drug withdrawal; Female; Health care; Human health and pathology; Humans; Life Sciences; Mental disorders; Middle Aged; Narcotics; Opioid-Related Disorders; Opioid-Related Disorders - diagnosis; Opioid-Related Disorders - epidemiology; Opioids; Pain; Patients; Primary care; Primary Health Care; Psychometrics; Questionnaires; Reproducibility of Results; Substance abuse treatment; Substance use disorder
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph192214845

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.