Evaluating the Current Opioid Misuse Measure (COMM) as a Tool to Inform Management of Vaso-occlusive Episodes Among Hospitalized Sickle Cell Disease Patients.

OBJECTIVES

Sickle cell disease (SCD) is associated with vaso-occlusive episodes (VOEs) that often require inpatient care. Parenteral opioids are recommended as first-line VOE treatment in hospitalized patients. The Current Opioid Misuse Measure (COMM) survey was used to screen for aberrant opioid use in SCD patients hospitalized for VOE. Goals were to estimate the proportion of positive screens and evaluate associations with length of stay (LOS), electronic health record (EHR) data, and Prescription Drug Monitoring Program (PDMP) assessments.

METHODS

SCD patients hospitalized for VOE were approached to complete COMM surveys. Descriptive statistics and multivariate modeling were used to evaluate whether COMM results were associated with LOS or secondary variables.

RESULTS

A total of 111 patients were approached and 89 completed surveys. Approximately 6 in 10 (57.3%) respondents screened positive for aberrant opioid use using a sensitive COMM threshold (≥9). A more specific threshold (≥13) identified about 3 in 10 (31.7%) of respondents. Positive COMM screens were more common among younger patients and those with a higher EHR risk index (Epic general risk score). COMM score was positively correlated with LOS (Spearman r =0.25, P =0.025), although this association was nonsignificant in survival models adjusted for sex and age ( P ≥0.081).

DISCUSSION: A high proportion of adults admitted for VOE screened positively using the COMM survey, which is a sensitive indicator of opioid misuse among outpatients. Our findings demonstrate feasibility of inpatient screening using the COMM survey and support further investigation of this tool for SCD patients hospitalized with VOE.