Development and Validation of a Low-Literacy Opioid Contract

Abstract Opioid contracts (OPCs) are often used to outline the criteria and circumstances for which opioid medications are prescribed. The purpose of this study was to develop and validate an English-language, low-literacy OPC. Specifically, the low-literacy OPC was designed to outline proper admini...

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Bibliographic Details
Published in:The journal of pain 2007-10, Vol.8 (10), p.759-766
Main Authors: Wallace, Lorraine S, Keenum, Amy J, Roskos, Steven E, McDaniel, Kelly S
Format: Article
Language:English
Subjects:
Analgesics, Opioid - therapeutic use
Anesthesia & Perioperative Care
Chronic opioid therapy
chronic pain
Comprehension
contract
Contracts - standards
Educational Status
Humans
noncancer pain
opioids
Pain - drug therapy
Pain Medicine
Patient Education as Topic - methods
Patient Education as Topic - standards
Pilot Projects
Teaching Materials - standards
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Summary:Abstract Opioid contracts (OPCs) are often used to outline the criteria and circumstances for which opioid medications are prescribed. The purpose of this study was to develop and validate an English-language, low-literacy OPC. Specifically, the low-literacy OPC was designed to outline proper administration of prescribed medication(s) as well as highlight patient responsibilities and expectations. A 4-step process was used to develop and validate the low-literacy OPC, including: (1) content identification; (2) attention to low-literacy guidelines; (3) evaluation based on Suitability Assessment of Materials (SAM) criteria; and (4) pilot testing with patients (n = 18) to assess comprehension. Final OPC content, presented largely in bulleted format, was based on current literature and consensus of the first 3 authors. The 4-part OPC was formatted on 8½ × 11 inch paper using 16- to 24-point size Arial-style font. The 6-page OPC, written at the 7th reading grade level, included 12 recognizable clipart-type illustrations to supplement written text. Two reviewers scored the OPC in the superior range based on total SAM percentage scores. Nineteen (n = 19) of the 26 statements were comprehended by all patients completing the pilot testing. Overall, the low-literacy OPC is comprehensive, valid, readable, and formatted according to established low-literacy guidelines. Perspective This study describes the development and validation of a low-literacy, English-language OPC. The OPC was formatted using low-literacy guidelines and validated with a sample of patients to confirm understanding of content. Accordingly, the low-literacy OPC is suitable for use in routine clinical practice.
ISSN:1526-5900
1528-8447
DOI:10.1016/j.jpain.2007.05.004