{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:37:08Z","timestamp":1772217428320,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and clinical predictors for PPA completion and non-adherence. This retrospective study covered consecutive cancer patients seen at a palliative care clinic at a safety net hospital between 1 September 2015 and 31 December 2019. We included patients 18 years or older with cancer diagnoses who received opioids. We collected patient characteristics at consultation and information regarding PPA. The primary purpose was to determine the frequency and predictors of patients with a PPA and non-adherence to PPAs. Descriptive statistics and multivariable logistic regression models were used for the analysis. The survey covered 905 patients having a mean age of 55 (range 18\u201393), of whom 474 (52%) were female, 423 (47%) were Hispanic, 603 (67%) were single, and 814 (90%) had advanced cancer. Of patients surveyed, 484 (54%) had a PPA, and 50 (10%) of these did not adhere to their PPA. In multivariable analysis, PPAs were associated with younger age (odds ratio [OR] 1.44; p = 0.02) and alcohol use (OR 1.72; p = 0.01). Non-adherence was associated with males (OR 3.66; p = 0.007), being single (OR 12.23; p = 0.003), tobacco (OR 3.34; p = 0.03) and alcohol use (OR 0.29; p = 0.02), contact with persons involved in criminal activity (OR 9.87; p &lt; 0.001), use for non-malignant pain (OR 7.45; p = 0.006), and higher pain score (OR 1.2; p = 0.01). In summary, we found that PPA non-adherence occurred in a substantial minority of patients and was more likely in patients with known NMOU risk factors. These findings underscore the potential role of universal PPAs and systematic screening of NMOU risk factors to streamline care.<\/jats:p>","DOI":"10.3390\/cancers15112943","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:17:33Z","timestamp":1685204253000},"page":"2943","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Adherence to Opioid Patient Prescriber Agreements at a Safety Net Hospital"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0963-0258","authenticated-orcid":false,"given":"Soraira","family":"Pacheco","sequence":"first","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linh M. T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Halphen","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikitha N.","family":"Samy","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel R.","family":"Wilson","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Sattler","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane E.","family":"Wing","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Feng","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rex A. D.","family":"Paulino","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pulin","family":"Shah","sequence":"additional","affiliation":[{"name":"Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5158-1157","authenticated-orcid":false,"given":"Supriyanka","family":"Addimulam","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riddhi","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4425-4566","authenticated-orcid":false,"given":"Curtis J.","family":"Wray","sequence":"additional","affiliation":[{"name":"McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Arthur","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-6607","authenticated-orcid":false,"given":"David","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jpainsymman.2005.06.007","article-title":"A Comparison of Symptom Prevalence in Far Advanced Cancer, AIDS, Heart Disease, Chronic Obstructive Pulmonary Disease and Renal Disease","volume":"31","author":"Solano","year":"2006","journal-title":"J. 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