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Papers of the Week

2022 Nov 11

Int J Environ Res Public Health



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


Laporte C, Fortin F, Dupouy J, Quirin A, Pereira B, Chenaf C, Delorme J, Maynié-François C, Rat C, Birebent J, Rambaud J, Duale C, Kerckhove N, Delage N, Authier N
Int J Environ Res Public Health. 2022 Nov 11; 19(22).
PMID: 36429565.


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.