Article Figures & Data
Tables
Demographic n (%) Mean (SD) Age (years) 46.13 (11.50) Ethnicity/Race White 567 (24.2) Black 1,648 (70.5) Other 124 (5.3) Sex Males 897 (38.3) Females 1,442 (61.7) Employment Full Time 318 (13.6) Unemployed 1,035 (44.2) Other 969 (41.4) Did not answer 17 (0.7) Marital Status Single 1,021 (43.7) In a relationship 388 (16.6) Married 391 (16.7) Divorced/Separated 439 (18.8) Widowed 94 (4) Did not answer 6 (0.3) Insurance Type Private 170 (7.3) Medicare 167 (7.1) Medicaid 144 (6.2) Indigent Care 1,669 (71.4) None 182 (7.8) Did not answer 7 (0.3) SD, standard deviation.
Research Assistant-Administered Screening Tools Computer-Administered Tool RxCAGE (CAGE modified to focus on prescription drug misuse) POMI-e (Expanded Prescription Opioid Misuse Index) Prescription misuse items Questions n (%) yes Questions n (%) yes Questions n (%) yes Have you ever felt the need to Cut down on your use of prescription drugs? 528 (22.6) Do you ever use more of your medication, that is, take a higher dose, than is prescribed for you? 350 (15.0) Taken more pills than the doctor told you to 113 (4.8) Have you ever felt Annoyed by remarks by your friends or loved ones made about your use of prescription drugs? 246 (10.5) Do you ever use your medication more often, that is, shorten the time between dosages, than is prescribed for you? 368 (15.7) Taken pills more often than the doctor told you 74 (3.2) Have you ever felt Guilty or remorseful about your use of prescription drugs? 219 (9.4) Do you ever need early refills for your medication? 274 (11.7) Used medicine prescribed for someone else 91 (3.9) Have you Ever used prescription drugs as a way to “get going” or “calm down?” 497 (21.2) Do you ever feel high or get a buzz after using your medication? 390 (16.7) Got the same medicine from more than one doctor 18 (0.8) Do you ever take your medication because you are upset, using the medication to relieve or cope with problems other than pain? 260 (11.1) Have you ever gone to multiple physicians, including emergency room doctors, seeking more of your medication? 99 (4.2) ≥1 item(s) positive 884 (37.8) ≥1 item(s) positive 847 (36.2) ≥ 1 item(s) positive 180 (7.7) ≥ 2items positive 358 (15.3) ≥2 items positive 435 (18.6) ≥ 2 items positive 81 (3.5) RxCAGE, Cut down, Annoyed, Guilty, and Eye-opener questionnaire modified to focus on prescription medications; POMI-e, Prescription Opioid Misuse Index expanded to include all prescription medications.
Measure Cut off score (equal or higher than) Sensitivity* (%) Specificity* (%) AUC 95% CI P value Rx-CAGE 1 62.8 64.3 0.54 0.52–0.57 .001 2 35.6 86.4 0.56 0.53–0.60 <.001 POMI-e 1 82.8 67.7 0.58 0.55–0.60 <.001 2 69.4 85.6 0.63 0.60–0.66 <.001 ROC, receiver operating characteristic; CI, confidential interval; AUC, area under the curve; RxCAGE, Cut down, Annoyed, Guilty, and Eye-opener questionnaire modified to focus on prescription medications; POMI-e, Prescription Opioid Misuse Index expanded to include all prescription medications.
↵* Having 1 or more positive Health Cheq Rx misuse items was used as the comparison.
- Table 4.
Participant Characteristics of Those at Risk for Prescription Misuse Based on POMI-e Scores of ≥2
Characteristics POMI-e <2 items endorsed (n = 1904) POMI-e ≥2 items endorsed (n = 435) P value n (%) Mean (SD) n (%) Mean (SD) Demographic Characteristics Age 46.43 (11.72) 44.8 (10.39) .004 Gender Male 694 (36.4) 203 (46.7) <.001 Female 1210 (63.6) 232 (53.3) Race White 429 (22.5) 138 (31.7) <.001 Black 1370 (72.0) 278 (63.9) Other 105 (5.5) 19 (4.4) Employment* Full time 273 (14.5) 45 (10.4) .015 Unemployed 818 (43.3) 217 (50.0) Other 797 (42.2) 172 (39.6) Education* Less than high school 429 (23.3) 111 (26.1) .132 High school 694 (37.7) 171 (40.1) College/advanced degree/technical training 717 (39.0) 144 (33.8) Medical Characteristics Chronic Diseases Hypertension 1034 (54.3) 225 (51.7) .330 Heart disease 209 (11.0) 225 (51.7) .702 Asthma 448 (23.5) 116 (26.7 .170 Chronic obstructive pulmonary disease 211 (11.1) 54 (12.4) .430 Arthritis 683 (35.9) 195 (44.8) .001 Migraines 253 (13.3) 71 (16.3) .098 Any chronic disease 1471 (77.3) 351 (80.7) .12 Sum number of chronic diseases 1.49 (1.19) 1.62 (1.22) .037 Past 30 days sleep rating Very good 209 (11.0) 18 (4.1) <.001 Good 514 (27.0) 63 (14.5) Fair 699 (36.7) 179 (41.1) Poor 482 (25.3) 175 (40.2) Overall health rating Very good or excellent 447 (23.5) 65 (14.9) <.001 Good 708 (37.2) 165 (37.9) Fair or poor 749 (39.3) 205 (47.1) Mental Health Characteristics Anxiety 514 (27.0) 212 (48.7) <.001 Depression 633 (33.2) 242 (55.6) <.001 Substance Use Characteristics Lifetime cigarette use* Smoked ≥100 cigarettes 806 (42.4) 276 (63.7) <.001 Smoked <100 cigarettes 410 (21.6) 76 (17.6) Never smoked 685 (36.0) 81 (18.7) Current smoker 757 (39.8) 280 (64.4) <.001 Illicit drug use Past 30 days illicit drug use 157 (8.2) 121 (27.8) <.001 CAGE-AID positive (≥1 positive) 117 (6.1) 110 (25.3) <.001 Alcohol use ≥ 2 TACE + with women or ≥1 CAGE + with men 226 (25.5) 132 (51.6) <.001 Positive for illicit drugs (as measured by CAGE-AID) or alcohol (as measured by ≥2 TACE for women or ≥1 CAGE for men) 285 (32.2) 164 (64.1) <.001 CAGE, Cut down, Annoyed, Guilty, and Eye-opener; CAGE-AID, CAGE Adapted to Include Drugs; TACE, Tolerance, Annoyance, Cut down, and Eye-opener; SD, standard deviation; POMI-e, Prescription Opioid Misuse Index expanded to include all prescription medications.
↵* Nonresponders to these survey questions were not included in the analysis.
