Document Detail


Analysis and interpretation of drug testing results from patients on chronic pain therapy: a clinical laboratory perspective.
MedLine Citation:
PMID:  19589103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent guidelines recommend monitoring for opioid and drug use in patients with chronic pain to detect use of undisclosed or illicit substances, and to determine compliance with prescribed medications. We examined the technical and clinical impact of drug testing for patients on chronic pain therapy in our clinical laboratory. METHODS: Testing volumes were obtained for 4 years. Volumes from three recent months were also examined in detail to determine average turnaround time, assay performance (i.e., number of positive screening and confirmatory tests and testing discrepancies) and consistency of patient results with medication history. RESULTS: Our testing volume continues to grow significantly, especially in the primary care setting, with an average yearly increase of 34%. Approximately 70% of patients confirmed positive for an opioid. Other drugs were positive in <30% of patients. Twenty-nine percent of patients tested positive for a medication without a prescription. Overall, the compliance rate was 85% indicating that 15% of patients had negative test results despite being prescribed a chronic pain medication. CONCLUSIONS: Clinical laboratories should consider the impact of these guidelines and examine options to optimize testing such as limiting or modifying the test panel.
Authors:
Stacy E F Melanson; Maria I Kredlow; Petr Jarolim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  47     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-31     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  971-6     Citation Subset:  IM    
Affiliation:
Division of Clinical Laboratories, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. semelanson@partners.org
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / chemistry,  metabolism,  therapeutic use*
Chronic Disease
Drug Monitoring*
Drug Prescriptions / statistics & numerical data
Humans
Pain / drug therapy*
Patient Compliance / statistics & numerical data*
Practice Guidelines as Topic
Substance Abuse Detection
Substance-Related Disorders / drug therapy*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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