Table 3.
Multivariable mixed effect models examining patient risk factors and opioid dose associated with problematic opioid behaviours.
| Indicators of potential extra medical opioid use (ORBIT) | Intermediate-high patient concerns about their opioid use (PODS) | Pharmaceutical opioid dependence (ICD-10) | |
|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Demographics | |||
| Age (per 10 years) | 0.803 (0.749–0.860) | 0.914 (0.847–0.987) | 0.765 (0.676–0.865) |
| Sex (female vs male) | 0.680 (0.574–0.805) | 0.747 (0.623–0.896) | 0.740 (0.561–0.977) |
| OME | |||
| Duration of continuous opioid use | 1.000 (0.999–1.001) | 1.000 (0.999–1.001) | 1.000 (0.998–1.002) |
| 0 OME mg/day | 1.166 (0.815–1.667) | 0.698 (0.480–1.016) | 1.211 (0.695–2.113) |
| 1–50 OME mg/day (ref) | 1 | 1 | 1 |
| >=50–90 OME mg/day | 1.150 (0.960–1.379) | 1.313 (1.090–1.581) | 1.000 (0.709–1.411) |
| >=90–199 OME mg/day | 1.370 (1.129–1.663) | 1.429 (1.171–1.743) | 1.219 (0.890–1.670) |
| >= 200 OME mg/day | 1.222 (0.977–1.528) | 1.546 (1.182–2.023) | 1.734 (1.209–2.487) |
| Pain factors | |||
| Pain duration (per 10 years) | – | 0.885 (0.820–0.954) | – |
| Pain severity | 0.988 (0.943–1.035) | 0.976 (0.928–1.026) | 0.956 (0.874–1.046) |
| Pain interference | 1.006 (0.965–1.048) | 1.032 (0.989–1.077) | 1.044 (0.964–1.130) |
| PSEQ score (per 10 points)a | 0.994 (0.987–1.000) | 0.995 (0.988–1.003) | 1.002 (0.991–1.014) |
| Pain catastrophising* | 1.005 (0.997–1.012) | 1.013 (1.005–1.022) | 1.016 (1.004–1.028) |
| Mental health and substance use | |||
| Depression (PHQ)b | 1.018 (1.001–1.035) | 1.086 (1.066–1.106) | 1.051 (1.022–1.081) |
| Anxiety (GAD)c | 1.029 (1.008–1.050) | 1.057 (1.034–1.079) | 1.037 (1.004–1.071) |
| Childhood abuse/neglect | 1.251 (1.059–1.477) | 1.129 (0.953–1.338) | 1.200 (0.891–1.618) |
| Substance dependence | 1.316 (1.080–1.603) | 1.205 (0.982–1.479) | 1.969 (1.394–2.782) |
Note: Associations examined using mixed effect models. Fully adjusted model controlled for significant bivariate variables identified in Appendix D.
OR = Odds Ratios. CI = 95% confidence intervals in parentheses.
The 1–49 OME per day was identified as the referent group to investigate whether higher OME was associated with more problematic behaviours as defined in Methods.
Opioid dependence was assessed as lifetime for baseline and past 12 months for other waves. Opioid dependence not collected at 1-year.
Pain self efficacy score.
PHQ-Patient Health Questionnaire.
GAD - Generalised Anxiety Disorder.
collected in years 3, 4 & 5.