Longitudinal Evaluation of the Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression in Patients with Cancer.

Abstract

The Commercially Insured health Plan Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) is an evidence-based screening tool to determine an individual's risk of opioid-induced respiratory depression (OIRD) or overdose. Chronic opioid use and changes in a patient's clinical status and/or medication regimen may impact OIRD or overdose risk. This study evaluated longitudinal CIP-RIOSORD scores over three consecutive visits. Data for eighty patients with cancer encompassed two-hundred and forty visits. Most patients were Caucasian women with metastatic gastrointestinal cancer. CIP-RIOSORD scores (mean ± SD) were 16.6 ± 15.4, 20.3 ± 15.7, and 19.1 ± 15.1 at visits 1, 2, and 3, respectively. Visit 1 CIP-RIOSORD scores were similar compared to visit 2 and visit 3 (p = 0.14-0.31). CIP-RIOSORD intraindividual variability was low to moderate; the median (range) coefficient of variation was 22.3% (0-173%). Beyond a baseline OIRD/overdose risk assessment, reevaluation of such risk using the CIP-RIOSORD does not to be performed at each palliative care visit.