Development of the barriers to opioid access scale among individuals with chronic pain

Background

Measurement of accessibility is a crucial pillar in assessing equity of access to pain treatment, particularly in the context of reducing opioid prescribing in response to rising overdose deaths in the United States.

Objectives

The aim of this study was to develop an instrument to measure barriers to prescription opioid access among individuals with chronic pain and test its psychometric properties.

Methods

This study used a cross-sectional online survey of a convenience sample of adults (>18 years) who reported any type of pain for at least 45 days or more in the previous 3 months. The survey captured demographic characteristics, self-reported medication use characteristics, and measures such as the Brief Pain Inventory-Short Form and the PROMIS Global Health measure, along with an item pool of potential questions that measure barriers to opioid access.

Results

Respondents (N = 200) were 89 % women, 86 % White, averaging 45.32 years old (SD:11.79), and reported poor quality life. Two subscales, Access to Care and Patient Concerns, were identified for the Barriers to Opioid Access Scale with good internal consistency reliability (α = 0.909 and 0.835, respectively). In multivariable analyses, the Access to Care subscale was associated with the PROMIS mental health score (−2.44; 95 % CI: −3.77, −1.11), and the Patient Concerns subscale was associated with self-reported frequency of opioid use (−0.70; 95 % CI: −0.99, −0.40).

Conclusions

The newly developed BOAS has the potential to serve as a tool for capturing quality of pain treatment as well as measuring the impact of policy changes on the quality of treatment provided to patients with chronic pain.