Tool Helps Emergency Providers ID Drug-Seeking Behavior
(HealthDay News) – Emergency providers are fairly accurate at identifying drug-seeking behavior, demonstrating fair agreement with prescription drug monitoring program criteria, according to a study published online July 11 in the Annals of Emergency Medicine.
Scott G. Weiner, MD, MPH, from the Tufts University School of Medicine in Boston, and colleagues conducted a prospective observational study involving 38 emergency providers using data from 544 patient visits to assess impressions of drug-seeking behavior. Patients presented with chief complaints of back pain, dental pain, or headache.
The researchers found that emergency providers had fair agreement with prescription drug monitoring program criteria for their impression of drug-seeking behavior. For identifying drug-seeking behavior, emergency providers had sensitivity of 63.2%, specificity of 72.7%, and positive predictive value of 41.2%. In 9.5% of cases, after exposure to prescription drug monitoring program data, emergency providers altered their plans to prescribe opioids at discharge, with 6.5% receiving opioids not previously planned and 3% not receiving opioids. Patient requests for opioid medication by name (odds ratio [OR], 1.91); multiple visits for the same complaint (OR, 2.5); suspicious history (OR, 1.88); symptoms out of proportion to examination (OR, 1.83); and hospital site (OR, 3.1) were significant predictors of drug-seeking behavior.
"Our results suggest that the use of select clinical criteria, as well as a prescription drug monitoring program to provide objective criteria, may reduce the risk of contributing to prescription drug abuse while still providing appropriate analgesia for emergency department patients," the authors write.