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      Development and validation of the Patient Opioid Education Measure

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          Abstract

          Background

          Although there are screening tools to aid clinicians in assessing the risk of opioid misuse, an instrument to assess opioid-related knowledge is not currently available. The purpose of this study was to develop a content-valid, understandable, readable, and reliable Patient Opioid Education Measure (POEM).

          Methods

          Using concept mapping, clinicians caring for patients with chronic pain participated in brainstorming, sorting, and rating need-to-know information for patients prescribed opioids. Concept mapping analyses identified seven clusters addressing knowledge and expectations associated with opioid use, including medicolegal issues, prescribing policies, safe use and handling, expected outcomes, side effects, pharmacology, and warnings.

          Results

          The 49-item POEM was verbally administered to 83 patients (average age 51.3 ± 9.8 years, 77.1% female, 47.1% African American) taking opioids for chronic nonmalignant pain. Patients averaged in total 63.9% ± 14.3% (range 23%–91%) correct responses on the POEM. The POEM demonstrated substantial test-retest reliability (interclass correlation coefficient 0.87). The POEM had a mean readability Lexile (L) score of 805.9 ± 257.3 L (equivalent to approximately a US fifth grade reading level), with individual items ranging from 280 L to 1370 L.

          Conclusion

          The POEM shows promise for rapidly identifying patients’ opioid-related knowledge gaps and expectations. Correcting misunderstandings and gaps could result in safer use of opioids in a clinical care setting.

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          Most cited references 50

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          Coefficient alpha and the internal structure of tests

           Lee Cronbach (1951)
          Psychometrika, 16(3), 297-334
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            Brief questions to identify patients with inadequate health literacy.

            No practical method for identifying patients with low heath literacy exists. We sought to develop screening questions for identifying patients with inadequate or marginal health literacy. Patients (n=332) at a VA preoperative clinic completed in-person interviews that included 16 health literacy screening questions on a 5-point Likert scale, followed by a validated health literacy measure, the Short Test of Functional Health Literacy in Adults (STOHFLA). Based on the STOFHLA, patients were classified as having either inadequate, marginal, or adequate health literacy. Each of the 16 screening questions was evaluated and compared to two comparison standards: (1) inadequate health literacy and (2) inadequate or marginal health literacy on the STOHFLA. Fifteen participants (4.5%) had inadequate health literacy and 25 (7.5%) had marginal health literacy on the STOHFLA. Three of the screening questions, "How often do you have someone help you read hospital materials?" "How confident are you filling out medical forms by yourself?" and "How often do you have problems learning about your medical condition because of difficulty understanding written information?" were effective in detecting inadequate health literacy (area under the receiver operating characteristic curve of 0.87, 0.80, and 0.76, respectively). These questions were weaker for identifying patients with marginal health literacy. Three questions were each effective screening tests for inadequate health literacy in this population.
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              Pharmaceutical overdose deaths, United States, 2010.

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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2013
                05 September 2013
                : 6
                : 663-681
                Affiliations
                [1 ]The Ohio State University, Department of Family Medicine, Columbus, OH, USA
                [2 ]Purdue Pharma LP, One Stanford Forum, Stanford, CT, USA
                [3 ]Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, MA, USA
                Author notes
                Correspondence: Lorraine S Wallace, The Ohio State University, Department of Family Medicine, 2231 North High Street, Columbus, OH 43201, USA, Tel +614 366 0787, Fax +614 293 2715, Email lorraine.wallace@ 123456osumc.edu
                Article
                jpr-6-663
                10.2147/JPR.S50715
                3775672
                24049456
                © 2013 Wallace et al. This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed.

                Categories
                Original Research

                Anesthesiology & Pain management

                questionnaire, opioid, knowledge, pain

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