150. Self-efficacy (PSEQ-2) score of

Abstract

<h3>BACKGROUND CONTEXT</h3> Self-efficacy and resiliency have been shown to be associated with back and neck pain. However, the literature correlating these measures to opioid use and PROMIS Scores are sparse. <h3>PURPOSE</h3> The aim of this study is to determine whether self-efficacy and resilience are associated with daily opioid users and whether an optimal threshold exists. We hypothesize self-efficacy and resilience will predict daily opioid use, opioid beliefs, pain and patient-reported outcomes. <h3>STUDY DESIGN/SETTING</h3> Retrospective review. <h3>PATIENT SAMPLE</h3> Adult spinal deformity patients with >4 levels fused at a single institution were given questionnaires preoperatively. <h3>OUTCOME MEASURES</h3> Opioid use, disability, patient activation and PROMIS scores. <h3>METHODS</h3> Patients with at least four levels fused were included. Self-efficacy was measured by the Self-Efficacy Questionnaire-2 (PSEQ-2). Resiliency was measured by the brief resilience scale (BRS). Threshold linear regression with Bayesian information criteria was utilized to identify the optimal threshold associated with daily opioid use. Multivariable analysis controlled for age, gender, education, income, ODI and PROMIS. <h3>RESULTS</h3> A total of 117 total patients were included in this study. Of these, 39 were daily opioid users. Mean age was 50 with 80 females. On bivariate analysis, patients with daily opioid use were more likely to have lower self-efficacy (21.5 vs 33.7), patient activation (62.5 vs 70.4), lower opioid barrier scores, and higher ODI disability (55.8 vs 37.6) (P>0.05). Threshold regression identified a cut-off of < 22 PSEQ-2 in predicting daily opioid use. On multivariable logistic regression, patients with < 22 PSEQ-2 had 5.63x higher odds of being a daily opioid user than those who did not. Further, < 22 PSEQ-2 was associated with lower patient activation, increased leg and back pain, higher ODI, higher PROMIS pain, fatigue, depression, and sleep, and lower PROMIS physical function and social satisfaction (P <0.05 for all). <h3>CONCLUSIONS</h3> A patient self-efficacy of <22 PSEQ-2 is associated with increased odds of being a daily opioid user. Further, this threshold is associated with more pain, disability, fatigue and depression. This information can be utilized to identify daily opioid users earlier on to optimize treatment for this unique population of ASD patients. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.