The stability and variations in the reporting of the CAGE-AID screening questionnaire in cancer patients.

Abstract

224 Background: The CAGE-AID questionnaire (CA) is a 4-item patient reported validated screening tool has been used to assess risk of aberrant drug related behaviors in cancer patients receiving opioids. Consistency of responses to the CA between settings is lacking. We evaluated the frequency of CA positivity in each setting and change in score (+ or -) between the first inpatient supportive care consultation and the first outpatient follow up visit within 3 months. Methods: A retrospective chart review was conducted to ascertain CA scores and clinical and demographic characteristics of consecutive adult patients who were initially seen during inpatient consultation (T1) and had an outpatient follow up within 3 months (T2). CA positivity was defined as a score of ≥2 in males or ≥1 in females, with score at T2 considered the gold standard. Results: ±SD) was 122 mg (150) at T2. CA was completed for 87% of T1 patients and 94% at T2. Scores are noted below. Hispanics (23%) were more likely to be CA positive as compared with Caucasians (15%) and African Americans (11%), p= 0.02. Between T1 and T2, CA score changed from negative to positive in 4% and positive to negative in 1% of patients. The Kappa coefficient for agreement of CA between T1 and T2 was 0.74 (0.62, 0.86), p= 0.02. Conclusions: The rate of completion and consistency of patient responses to the CA was high irrespective of clinical setting. Between 10-13% of patients with advanced cancer are at increased risk for aberrant opioid use. Further studies are needed to evaluate the reasons for a change in CA scores between T1 to T2 in some patients so as not to miss those at higher risk for aberrant behaviors in need of additional monitoring and support. [Table: see text]