- Title
- Development of a brief tool for monitoring aberrant behaviours among patients receiving long-term opioid therapy: the Opioid-Related Behaviours In Treatment (ORBIT) scale
- Creator
- Larance, Briony; Bruno, Raimondo; Mattick, Richard P.; Lintzeris, Nicholas; Degenhardt, Louise; Black, Emma; Brown, Amanda; Nielsen, Suzanne; Dunlop, Adrian; Holland, Rohan; Cohen, Milton
- Relation
- NHMRC.1073858, 1041472, 1013803 & 1045318
- Relation
- Drug and Alcohol Dependence Vol. 159, p. 42-52
- Publisher Link
- http://dx.doi.org/10.1016/j.drugalcdep.2015.11.026
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2016
- Description
- Background: Early identification of problems is essential in minimising the unintended consequences of opioid therapy. This study aimed to develop a brief scale that identifies and quantifies recent aberrant behaviour among diverse patient populations receiving long-term opioid treatment. Method: 40 scale items were generated via literature review and expert panel (N= 19) and tested in surveys of: (i) N= 41 key experts, and (ii) N= 426 patients prescribed opioids >3 months (222 pain patients and 204 opioid substitution therapy (OST) patients). We employed item and scale psychometrics (exploratory factor analyses, confirmatory factor analyses and item-response theory statistics) to refine items to a brief scale. Results: Following removal of problematic items (poor retest-reliability or wording, semantic redundancy, differential item functioning, collinearity or rarity) iterative factor analytic procedures identified a 10-item unifactorial scale with good model fit in the total sample (N= 426; CFI = 0.981, TLI = 0.975, RMSEA = 0.057), and among pain (CFI = 0.969, TLI = 0.960, RMSEA = 0.062) and OST subgroups (CFI = 0.989, TFI = 0.986, RMSEA = 0.051). The 10 items provided good discrimination between groups, demonstrated acceptable test-retest reliability (ICC 0.80, 95% CI 0.60-0.89; Cronbach's alpha = 0.89), were moderately correlated with related constructs, including opioid dependence (SDS), depression and stress (DASS subscales) and Social Relationships and Environment domains of the WHO-QoL, and had strong face validity among advising clinicians. Conclusions: The Opioid-Related Behaviours In Treatment (ORBIT) scale is brief, reliable and validated for use in diverse patient groups receiving opioids. The ORBIT has potential applications as a checklist to prompt clinical discussions and as a tool to quantify aberrant behaviour and assess change over time.
- Subject
- chronic pain; opioid analgesics; opioid substitution therapy; addiction; medication non-adherence
- Identifier
- http://hdl.handle.net/1959.13/1321354
- Identifier
- uon:24335
- Identifier
- ISSN:0376-8716
- Language
- eng
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