Implementation of SOAP-R Screening Tool to Assess Adult Opioid Misuse in Rural Clinics

Introduction: Opioid misuse is an epidemic in the United States with estimates of opioid overdose deaths increasing 156% between 2010 and 20151. Rural communities are disproportionately burdened. Barriers in the rural health systems include distance, cost, and lack of methadone treatment clinics. The aim of this project is to assess the effectiveness of an opioid screening questionnaire in a rural clinic. Methods: Implementation of the Revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R) was assessed over a 4-week period. Patients who were prescribed opioids twice over a two-week period and who were age 19-80 were included. Cancer patients on opioid therapy were excluded. Results: Out of the 15 patients who were eligible to take the questionnaire, 11 chose to participate (70%). Three patients refused and one patient was not offered the questionnaire. None of the patients who took the questionnaire tested at risk for opioid abuse. Conclusion: Implementation of the SOAPP-R screening tool may alert physicians to potential misuse of opioids leading to earlier intervention and treatment for such patients. The present study showed an increase of screening from 0% to 73%. Future Plan Do Act (PDSA) cycles should include larger sample sizes. To assess the impact and influence of SOAPP-R, researchers should measure whether screening leads to early intervention.