Efficacy of the Opioid Compliance Checklist to Monitor Chronic Pain Patients Receiving Opioid Therapy in Primary Care.

UNLABELLED: The Opioid Compliance Checklist (OCC) is a self-report measure for chronic pain patients prescribed long-term opioid therapy. The original measure includes 'yes' or 'no' items that reflect the content of a typical opioid therapy agreement. The aim of the study was to assess the efficacy of the OCC for monitoring opioid adherence among chronic noncancer pain patients within primary care. One hundred seventy-seven chronic pain patients were recruited as part of a larger study from 8 primary care centers. All patients completed pre- and poststudy measures as well as the OCC once a month for 6 months. Patients were classified on the Drug Misuse Index on the basis of results of urine toxicology screens, physician misuse behavior ratings, and self-report questionnaire results. Patients treated in primary care reported fewer incidences of misuse compared with patients from pain specialty centers in the original study. Three items from the OCC were found to be most predictive of opioid misuse measured according to the area under the curve (AUC = .681) analyses, although use of the 8-item OCC seemed equally valid. By the end of the study the patients reported lower scores on the OCC (greater compliance with their opioid medication). Results of this study suggest that the psychometric parameters of the shortened 8-item OCC are not based solely on unique characteristics of the initial validation sample. The OCC seemed to be a reliable and valid screening tool to help detect current and future aberrant drug-related behavior and nonadherence among chronic pain patients in primary care. PERSPECTIVE: The OCC is a brief 'yes' or 'no' questionnaire that reflects areas of compliance that are often included in an opioid therapy agreement. Repeated administrations of the OCC among patients who receive opioids for chronic pain can increase the chance of identifying those who misuse or are likely to misuse opioids.