Family physicians’ proficiency in urine drug test interpretation

2007 ◽  
Vol 3 (6) ◽  
pp. 333 ◽  
Author(s):  
Gary M. Reisfield, MD ◽  
Fern J. Webb, PhD ◽  
Roger L. Bertholf, PhD ◽  
Paul A. Sloan, MD ◽  
George R. Wilson, MD
Keyword(s):  
Family Medicine ◽  
Drug Testing ◽  
Opioid Therapy ◽  
Physician Education ◽  
Test Interpretation ◽  
Multiple Choice Questions ◽  
Drug Test ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Urine Drug Test

Objective: To determine the proficiency in urine drug test interpretation among family medicine physicians who order these tests to monitor adherence in their patients on chronic opioid therapy.Methods: A seven-question instrument, consisting of six, five-option, single-best-answer multiple choice questions and one yes/no question was administered to 80 family medicine physicians attending a University of Kentucky Family Medicine Review Course. We calculated frequencies and performed χ2 analyses to examine bivariate associations between urine drug test utilization and interpretive knowledge.Results: The instrument was completed by 60/80 (75 percent) of eligible physicians (44 order urine drug testing; 16 do not). None of the physicians who order urine drug testing answered more than five of the seven questions correctly, and only 20 percent answered more than half correctly. Physicians who order urine drug testing performed better than physicians who do not order urine drug testing on only four of the seven questions, although there were no statistically significant differences between the groups on any question.Conclusions: Family medicine physicians who order urine drug testing to monitor their patients on chronic opioid therapy are not proficient in their interpretation. This study highlights the need for improved physician education in this area. It is imperative for physicians to work closely with certified laboratory professionals when ordering and interpreting urine drug tests.

Urine drug test interpretation: What do physicians know?

2007 ◽  
Vol 3 (2) ◽  
pp. 80 ◽  
Author(s):  
Gary M. Reisfield, MD ◽  
Roger Bertholf PhD ◽  
Robert L. Barkin, MBA, PharmD ◽  
Fern Webb, PhD ◽  
George Wilson, MD
Keyword(s):  
Multiple Choice ◽  
Opioid Therapy ◽  
Physician Education ◽  
Test Interpretation ◽  
Chronic Opioid Therapy ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

Objective: To determine the level of urine drug test (UDT) interpretive knowledge of physicians who use these instruments to monitor adherence in their patients on chronic opioid therapy.Methods: A seven-question instrument consisting of six five-option, single-best-answer multiple choice ques¬tions and one yes/no question was completed by 114 physicians (77 who employ UDT and 37 who do not) attending one of three regional opioid education confer¬ences. We calculated frequencies and performed %2 analyses to examine bivariate associations between UDT utilization and interpretive knowledge.Results: The instrument was completed by 80percent of eligible respondents. None of the physicians who employ UDT answered all seven questions correctly, and only 30 percent answered more than half correctly. Physicians who employ UDTperformed no better on any of the ques¬tions than physicians who do not employ UDT.Conclusions: Physicians who employ UDT to monitor patients receiving chronic opioid therapy are not profi¬cient in test interpretation. This study highlights the need for improved physician education; it is imperative for physicians to work closely with certified laboratoryprofes- sionals when ordering and interpreting these tests.

A Prediction Model for Positive Infant Meconium and Urine Drug Tests

2020 ◽  
Author(s):  
Elizabeth A. Simpson ◽  
David A. Skoglund ◽  
Sarah E. Stone ◽  
Ashley K. Sherman
Keyword(s):  
Prediction Model ◽  
Drug Testing ◽  
Clinical Decision Making ◽  
Drugs Of Abuse ◽  
Clinical Decision ◽  
P Value ◽  
Test Characteristics ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

Objective This study aimed to determine the factors associated with positive infant drug screen and create a shortened screen and a prediction model. Study Design This is a retrospective cohort study of all infants who were tested for drugs of abuse from May 2012 through May 2014. The primary outcome was positive infant urine or meconium drug test. Multivariable logistic regression was used to identify independent risk factors. A combined screen was created, and test characteristics were analyzed. Results Among the 3,861 live births, a total of 804 infants underwent drug tests. Variables associated with having a positive infant test were (1) positive maternal urine test, (2) substance use during pregnancy, (3) ≤ one prenatal visit, and (4) remote substance abuse; each p-value was less than 0.0001. A model with an indicator for having at least one of these four predictors had a sensitivity of 94% and a specificity of 69%. Application of this screen to our population would have decreased drug testing by 57%. No infants had a positive urine drug test when their mother's urine drug test was negative. Conclusion This simplified screen can guide clinical decision making for determining which infants should undergo drug testing. Infant urine drug tests may not be needed when a maternal drug test result is negative. Key Points

Random urine drug testing among patients receiving opioid therapy for cancer pain

Cancer ◽  
2020 ◽  
Author(s):  
Joseph A. Arthur ◽  
Michael Tang ◽  
Zhanni Lu ◽  
David Hui ◽  
Kristy Nguyen ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Drug Testing ◽  
Opioid Therapy ◽  
Urine Drug Testing ◽  
Urine Drug

Legal issues related to drug testing in the clinical laboratory.

1988 ◽  
Vol 34 (3) ◽  
pp. 633-636 ◽  
Author(s):  
R T Chamberlain
Keyword(s):  
Drug Testing ◽  
Clinical Laboratory ◽  
Scientific Evidence ◽  
Legal Issues ◽  
Third Party ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chain Of Custody ◽  
Urine Drug Test ◽  
The Many

Abstract As has been reported many times by the lay press, urine drug testing may pose some unique challenges. The clinical laboratory interested in industrial drug testing (typically known as employee drug testing) should be aware of the many challenges that may be brought on by the fact that the result may be contested in an adversarial proceeding. This is what makes the urine drug test a forensic test. It may be one piece of evidence or the only piece of evidence used in an adversarial proceeding that may decide on punitive or rehabilitative action against an employee. As a result, unique standards for governmental contract laboratories have been proposed from the National Institute on Drug Abuse, and special proficiency testing and accreditation procedures have been promoted by professional societies. These standards illustrate the sensitive nature of the results. Because the results are subject to adversarial proceedings, all parties concerned in the testing process should be aware of the legal issues surrounding urine drug testing. There are constitutional and statutory issues as well as tort issues such as negligence, defamation, invasion of privacy, battery, infliction of emotional distress, and others. Laboratories should be especially aware of these issues, since they may be brought in as a third-party defendant to a suit or brought in as a participant in gathering the evidence. The laboratory should also be aware of other legal ramifications such as chain of custody, expert testimony, and the acceptability of scientific evidence.

Urine Drug Testing in a Family Medicine Residency Practice

2017 ◽  
Vol 11 (3) ◽  
pp. 242-243 ◽  
Author(s):  
Hunter E. Woodall ◽  
Natawadee Young ◽  
Amanda Davis ◽  
Mary Beth Wright
Keyword(s):  
Family Medicine ◽  
Drug Testing ◽  
Family Medicine Residency ◽  
Urine Drug Testing ◽  
Urine Drug

scholarly journals Urine Drug Test Interpretation: An Educational Program's Impact on Resident Knowledge and Comfort Level

MedEdPORTAL ◽  
2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Whitney Aultman ◽  
Janna Fett ◽  
Colleen Lauster ◽  
Sarah Muench ◽  
Alexandra Halalau
Keyword(s):  
Comfort Level ◽  
Test Interpretation ◽  
Drug Test ◽  
Urine Drug ◽  
Urine Drug Test

scholarly journals Repeated Quantitative Urine Toxicology Analysis May Improve Chronic Pain Patient Compliance with Opioid Therapy

2017 ◽  
Vol 2 (20;2) ◽  
pp. s135-s145 ◽  
Author(s):  
Nebojsa Nick Knezevic
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Retrospective Analysis ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Opioid Therapy ◽  
Urine Toxicology ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Improve Compliance

Background: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic benign pain, many Americans continue to seek pain relief through opioid consumption. Assuring compliance of these patients may be a difficult aspect of proper management even with regular behavioral monitoring. Objective: The purpose of this study was to accurately assess the compliance of chronic opioidconsuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing (UDT) could improve compliance. Study Design: Retrospective analysis of prospectively collected data. Setting: Outpatient pain management clinic. Methods: After Institutional Review Board (IRB) approval, a retrospective analysis of data for 500 patients was conducted. We included patients who were aged 18 years and older who were treated with opioid analgesic medication for chronic pain. Patients were asked to provide supervised urine toxicology specimens during their regular clinic visits, and were asked to do so without prior notification. The specimens were sent to an external laboratory for quantitative testing using liquid chromatography-tandem mass spectrometry. Results: Three hundred and eighty-six (77.2%) patients were compliant with prescribed medications and did not use any illicit drugs or undeclared medications. Forty-one (8.2%) patients tested positive for opioid medication(s) that were not prescribed in our clinic; 8 (1.6%) of the patients were positive for medication that was not prescribed by any physician and was not present in the Illinois Prescription Monitoring Program; 5 (1%) patients tested negative for prescribed opioids; and 60 (12%) patients were positive for illicit drugs (8.6% marijuana, 3.2% cocaine, 0.2% heroin). Repeated UDTs following education and disclosure, showed 49 of the 77 patients (63.6%) had improved compliance. Limitations: This was a single-site study and we normalized concentrations of opioids in urine with creatinine levels while specific gravity normalization was not used. Conclusions: Our results showed that repeated UDT can improve compliance of patients on opioid medications and can improve overall pain management. We believe UDT testing should be used as an important adjunctive tool to help guide clinical decision-making regarding opioid therapy, potentially increasing future quality of care. Key words: Urine toxicology analysis, chronic pain, opioids, compliance, pain management, urine drug testing, urine drug screening

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