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Pain Research and Treatment
Volume 2014, Article ID 584986, 9 pages
Research Article

Risk Assessment of Opioid Misuse in Italian Patients with Chronic Noncancer Pain

1Division of Psychology, San Bortolo Hospital, Via Rodolfi, 36100 Vicenza, Italy
2Pain Management Unit, S. Antonio Hospital, Padua, Italy
3Pain Management and Palliative Care Unit, San Bortolo Hospital, Vicenza, Italy

Received 29 January 2014; Revised 23 June 2014; Accepted 3 July 2014; Published 10 August 2014

Academic Editor: Robert L. Barkin

Copyright © 2014 Renata Ferrari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Opioid therapy in patients with chronic noncancer pain must be preceded by evaluation of the risk of opioid misuse. The aim of this study was to evaluate the predictive validity of the Italian translation of the Pain Medication Questionnaire (PMQ) and of the Diagnosis Intractability Risk and Efficacy Score (DIRE) in chronic pain patients. Design. 75 chronic noncancer pain patients treated with opioids were enrolled and followed longitudinally. Risk of opioid misuse was evaluated through PMQ, DIRE, and the physician’s clinical evaluation. Pain experience and psychological characteristics were assessed through specific self-report instruments. At follow-ups, pain intensity, aberrant drug behaviors, and presence of the prescribed opioid and of illegal substances in urine were also checked. Results. PMQ demonstrated good internal consistency (Cronbach’s ) and test-retest reliability . Significant correlations were found between higher PMQ scores and the number of aberrant drug behaviors detected at 2-, 4-, and 6-month follow-ups . Also the DIRE demonstrated good predictive validity. Conclusions. The results obtained with specific tools are more reliable than the clinician’s evaluation alone in predicting the risk of opioid misuse; regular monitoring and psychological intervention will contribute to improving compliance and outcome of long-term opioid use.