The Effects of Risk Stratifying Patients with the Screener and Opioid Assessment for Patients with Pain (SOAPP-R) on Aberrant Drug-Taking Behavior in the Primary Care Population

Abstract

As the opioid epidemic continues to negatively affect morbidity and mortality in the United States, providers must implement risk reduction strategies when prescribing opioids. Evidence suggests that risk screening tools are underutilized. The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a tool designed to risk stratify patients being considered for treatment with opioids. The purpose of this quasi-experimental evidence-based improvement project was to determine if screening patients with the SOAPP-R reduces aberrant drug-taking behavior in chronic pain patients being evaluated for treatment with opioid therapy over three months in the primary care setting. A pre-intervention group of 67 patients undergoing no standardized risk screening was recruited using ICD-10 codes indicative of chronic pain. An independent sample of 58 patients screened with the SOAPP-R constituted the post-intervention group and was recruited using the same ICD-10 codes. The primary outcomes were measured by accessing the electronic health record and included the incidence of early refills of controlled substances and filling controlled substances from more than one provider across multiple practices. Results did not demonstrate a statistically significant difference in early refills of controlled substances between the pre- and post-intervention groups. A decrease in the incidence of filling controlled substances from more than one provider across multiple practices was observed in the post-intervention group that approached statistical significance. The implementation of risk stratification would be most impactful in settings in which opioids are commonly prescribed to treat chronic pain.