Patients being prescribed regular opioid painkillers should have their compliance monitored with regular urine tests, according to US researchers.
They argue regular testing of patients prescribed the painkillers can keep them compliant with the therapy and also highlight any illicit drug they might be taking so appropriate support can be offered.
“We believe urine drug testing should be used as an important adjunctive tool”
Researchers at the Advocate Illinois Masonic Medical Center in Chicago conducted a retrospective analysis of data on 500 adult patients who were treated with opioids for chronic pain for more than three months.
Patients were randomly chosen and asked to provide urine toxicology specimens during their regular outpatients clinic visits without prior notification.
The specimens were sent to an external laboratory for quantitative testing by using liquid chromatography-tandem mass spectrometry.
A total of 386 (77.2%) of patients were compliant with prescribed medication and did not use any illicit drugs or unlisted medications, while five tested negative for their prescribed opioids.
A further 50 were positive for at least one opioid medication that was not prescribed in the clinic and 60 tested positive for illicit drugs – either marijuana, cocaine or heroin.
Repeated urine testing, followed after re-education and disclosure, showed 49 of the 77 patients (63.6%) that had urine toxicology testing repeated had improved compliance.
Lead study author Dr Nick Knezevic said: “Our results showed that repeated urine drug testing can improve compliance of patients on opioid medication and can improve overall pain management.
“We believe urine drug testing should be used as an important adjunctive tool to help guide with various medical decisions, potentially increasing future quality of care,” he said.
“However, the remaining question is how frequently testing should be carried out,” he noted.
The research findings were presented at this year’s World Congress of Anaesthesiologists, taking place between 28 August and 2 September in Hong Kong.
The study was presented at the event as a poster (see attached PDF below) and has been accepted for future publication in a medical journal.