Validation of a brief opioid compliance checklist for patients with chronic pain

Robert N. Jamison, Marc O. Martel, Robert R. Edwards, Jing Qian, Kerry Anne Sheehan, Edgar L. Ross

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


There has been a need for a brief assessment tool to determine compliance with use of prescribed opioids for pain. The purpose of this study was to develop and begin the validation of a brief and simple compliance checklist (Opioid Compliance Checklist [OCC]) for chronic pain patients prescribed long-term opioid therapy. A review of the literature of opioid therapy agreements led to a 12-item OCC that was repeatedly administered to 157 patients who were taking opioids for chronic pain and followed for 6 months. Validation of the OCC was conducted by identifying those patients exhibiting aberrant drug-related behavior as determined by any of the following: positive urine toxicology screen, a positive score on the Prescription Drug Use Questionnaire interview or Current Opioid Misuse Measure, and/or ratings by staff on the Addiction Behavior Checklist. Of the original 12 items, 5 OCC items appeared to best predict subsequent aberrant behaviors based on multivariate logistic regression analyses (cross-validated area under the receiver operating characteristic curve = .67). Although further testing is needed, these results suggest that the OCC is an easy-touse, promising measure in monitoring opioid adherence among persons with chronic pain. Perspective: This study presents validation of a brief 5-item compliance checklist for use with chronic pain patients prescribed long-term opioid therapy. This measure asks patients about aberrant drug-related behavior over the past month, and any positive response indicates problems with adherence with opioids. Further cross-validation testing is needed.

Original languageEnglish (US)
Pages (from-to)1092-1101
Number of pages10
JournalJournal of Pain
Issue number11
StatePublished - 2014
Externally publishedYes


  • Aberrant drug behaviors
  • Adherence
  • Chronic pain
  • Compliance
  • Opioids
  • Substance abuse

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology


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