ArticleDrug and alcohol dependence2021
Validation and threshold identification of a prescription drug monitoring program clinical opioid risk metric with the WHO alcohol, smoking, and substance involvement screening test.
Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Evaluating the validity and performance of a modifiable prediction model to predict new long-term opioid use in prescription drug monitoring programs.JAMIA open · 2026Article
- Vigilant Algorithms and the Contagion of Risk in Automated Opioid Risk Assessment.Sociology of health & illness · 2026Article
- A short communication of pain outcomes following a pharmacist-delivered alcohol and opioid use reduction intervention.Drug and alcohol dependence reports · 2026Article
- Opioid misuse detection from cognitive and physiological data with temporal fusion deep learning.Drug and alcohol dependence · 2025Article
- Barriers and facilitators to the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients.Journal of substance use and addiction treatment · 2025Article
- CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool-a protocol paper.Addiction science & clinical practice · 2024Article
- Letter to the Editor Responding to "Paths Forward for Clinicians Amidst the Rise of Unregulated Clinical Decision Support Software: Our Perspective on NarxCare".Journal of general internal medicine · 2024Article
- Engaging community pharmacies in practice-based research: Lessons from opioid-focused research.Research in social & administrative pharmacy : RSAP · 2024Article
- Paths Forward for Clinicians Amidst the Rise of Unregulated Clinical Decision Support Software: Our Perspective on NarxCare.Journal of general internal medicine · 2024Article
- Effectiveness of Long-Term Opioid Therapy for Chronic Pain in an Outpatient Palliative Medicine Clinic.Journal of palliative medicine · 2024Article
- A call for better validation of opioid overdose risk algorithms.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Mapping prescription drug monitoring program data to self-report measures of non-medical prescription opioid use in community pharmacy settings.Research in social & administrative pharmacy : RSAP · 2023Article
- Mitigating algorithmic bias in opioid risk-score modeling to ensure equitable access to pain relief.Nature medicine · 2023Article
- Evaluation of Interprofessional Quality Improvement Interventions Led by an Ambulatory Care Pharmacist on Adherence to a Controlled Substance Agreement Policy.Innovations in pharmacy · 2023Article
- Pain Severity and Interference and Substance Use Among Community Pharmacy Patients Prescribed Opioids: A Secondary Analysis of the PHARMSCREEN Study.The journal of pain · 2022Article
- Risky alcohol use among patients dispensed opioid medications: A clinical community pharmacy study.Drug and alcohol dependence · 2022Article
- Validation of the tobacco, alcohol, prescription medication, and other substance use (TAPS) tool with the WHO alcohol, smoking, and substance Involvement screening test (ASSIST).Addictive behaviors · 2022Article
- Associations between elevated depressive symptoms and substance use, prescription opioid misuse, overdose history, pain, and general health among community pharmacy patients prescribed opioids.Substance abuse · 2022Article
- Concomitant Cannabis Misuse and Associations with Depression, Pain and Substance Misuse among Patients Prescribed Opioids.Pharmacy (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundPrescription drug monitoring programs (PDMPs) are critical for pharmacists to identify risky opioid medication use. We performed an independent evaluation of the PDMP-based Narcotic Score (NS) metric.
methodsThis study was a one-time, cross-sectional health assessment within 19 pharmacies from a national chain among adults picking-up opioid medications. The NS metric is a 3-digit composite indicator. The WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was the gold-standard to which the NS metric was compared. Machine learning determined optimal risk thresholds; Receiver Operating Characteristic curves and Spearman (P) and Kappa (K) coefficients analyzed concurrent validity. Regression analyses evaluated participant characteristics associated with misclassification.
resultsThe NS metric showed fair concurrent validity (area under the curve≥0.70; K=0.35; P = 0.37, p < 0.001). The ASSIST and NS metric categorized 37% of participants as low-risk (i.e., not needing screening/intervention) and 32.3% as moderate/high-risk (i.e., needing screening/intervention). Further, 17.2% were categorized as low ASSIST risk but moderate/high NS metric risk, termed false positives. These reported disability (OR=3.12), poor general health (OR=0.66), and/or greater pain severity/interference (OR=1.12/1.09; all p < 0.05; i.e., needing unmanaged-pain screening/intervention). A total of 13.4% were categorized as moderate/high ASSIST risk but low NS metric risk, termed false negatives. These reported greater overdose history (OR=1.24) and/or substance use (OR=1.81-12.66; all p < 0.05).
conclusionsThe NS metric could serve as a useful initial universal prescription opioid-risk screener given its: 1) low-burden (i.e., no direct assessment); 2) high accuracy (86.5%) of actionable data identifying low-risk patients and those needing opioid use/unmanaged pain screening/intervention; and 3) broad availability.
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