Behavioral, mental, and physical health characteristics and opioid medication misuse among community pharmacy patients: A latent class analysis

摘要

Abstract Background Community pharmacists are well-positioned to address the US opioid medication crisis, which has created a need to detect misuse risk in order to provide optimal patient care. Objectives This study sought to identify community pharmacy patient subgroups at risk for opioid medication misuse. Methods This study was a cross-sectional survey that examined behavioral, mental, and physical health characteristics among patients filling opioid pain medications. A convenience sample of adult patients filling opioid pain medications who were not receiving cancer treatment were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Patient subgroups were identified using latent class analysis. Latent class regression analysis was used to examine the association between subgroup membership and misuse. Results A total of 333 patients completed the survey (response rate 71.4%). Latent class analysis results showed that a 3-class solution best fit the data, which were labeled: mental health (8.4%, n?=?28), poor health (79.6%, n?=?265), and hazardous alcohol use (12%, n?=?40). Individuals within the mental health subgroup had an increased risk for opioid medication misuse (Odds Ratio?=?6.23, 95% CI?=?5.13–7.33). Conclusion These findings demonstrate heterogeneity of this population receiving prescribed opioids and the potential to identify subgroups with high misuse risk. These findings also support routine screening of patients filling opioid medications and suggest the need for evidence-based patient-centered intervention development. Highlights ? The US opioid medication epidemic has brought an urgent need for pharmacists to regularly screen patients for misuse. ? Latent class analysis affords an analytical advancement for understanding patient misuse risk. ? Three subgroups of patients immerged from the latent class analysis; each group characterized by pain as well as other unique risk factors. ? Results showed patients within the mental health subgroup had elevated risk for misusing their opioid medication.