dire_opioid_score: DIRE Score for Opioid Treatment

In cliot: Clinical Indices and Outcomes Tools

DIRE Score for Opioid Treatment

Description

Calculates the DIRE Score (Diagnosis, Intractability, Risk, Efficacy) to predict the efficacy and compliance of long-term opioid analgesic treatment for non-cancer pain. The score evaluates 7 factors, each rated on a scale of 1 to 3.

Usage

dire_opioid_score(diagnosis, intractability, risk_psychological, risk_chemical,
                  risk_reliability, risk_social, efficacy)

Arguments

diagnosis	Numeric (1-3). 1: Benign condition with minimal objective findings. 2: Slowly progressive condition with moderate objective findings. 3: Advanced condition with clear objective findings.
intractability	Numeric (1-3). 1: Few therapies tried, patient passive. 2: Most therapies tried, limited response. 3: Fully engaged, multiple therapies failed.
risk_psychological	Numeric (1-3). 1: Severe personality disorder or mental illness. 2: Moderate or treated mental illness. 3: Good psychological stability.
risk_chemical	Numeric (1-3). 1: Active or recent addiction. 2: History of addiction in remission. 3: No history of chemical dependency.
risk_reliability	Numeric (1-3). 1: History of medication misuse, missed appointments. 2: Occasional difficulties with compliance. 3: Highly reliable, compliant with care.
risk_social	Numeric (1-3). 1: Chaotic life, poor support. 2: Moderate support. 3: Supportive family/friends, stable life.
efficacy	Numeric (1-3). 1: Poor function or minimal pain relief with opioids. 2: Moderate benefit. 3: Good improvement in function and pain.

Value

A list containing:

DIRE_Score	The calculated total score (Range 7-21).
Suitability	Interpretation of the score (Suitable >= 14, Not Suitable <= 13).

References

Belgrade MJ, Schamber CD, Lindgren BR. The DIRE score: predicting outcomes of opioid prescribing for chronic pain. J Pain. 2006;7(9):671-681. doi:10.1016/j.jpain.2006.03.001

Examples

# Example 1: Poor Candidate
# All items scored 1
dire_opioid_score(1, 1, 1, 1, 1, 1, 1)

# Example 2: Good Candidate
# All items scored 3
dire_opioid_score(3, 3, 3, 3, 3, 3, 3)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.