Screening opioid induced androgen deficiency using ADAM questionnaire

Purpose: The adverse effects of opioid-induced androgen deficiency (OPIAD) in men on chronic opioids continue to rise with the growing aging population and the increased rate of opioid prescriptions. OPIAD affects diabetes mellitus, hyperlipidemia, obesity, erectile dysfunction, osteoporosis, anemia, depression, and cardiovascular disease. Providers can improve care by screening for androgen deficiency in men on chronic opioids and referring men who test positive for OPIAD for evaluation of hypogonadism. The purpose of this project was to improve the identification of the patients with androgen deficiency secondary to chronic opioid use and refer them for follow-up evaluation of OPIAD. Methodology: This quality improvement pilot project used the ADAM questionnaire to identify androgen deficiency in men on chronic opioids. Men who screened positive were referred for further evaluation of OPIAD. A follow-up phone survey determined the benefit of the ADAM in screening men with OPIAD and patient satisfaction with the project. The survey of the provider assessed the efficacy and sustainability of the project. Results: Ten men participated in the screening for OPIAD, and 9 men (90%) screened positive for androgen deficiency. Of those who screened positive, 8 completed the followed-up phone survey, and 7 (87.6%) reported follow-ups with their provider for evaluation of OPIAD. Seven Two individuals (33.3%) had changes to their treatment regimen or received a referral to an endocrinologist. Participants’ average satisfaction score with the project was 4.6 out of 5, with a median satisfaction score of 5. Implications for Practice: This pilot project showed a high prevalence of androgen deficiency in men on chronic use of opioids at this clinical site. The results indicate the usefulness of the ADAM questionnaire in identifying OPIAD in men on chronic opioids. Integrating the ADAM questionnaire in practice enables the detection and treatment of OPIAD.D.N.P.Includes bibliographical reference