ArticleJournal of general internal medicine2020
Provider Misinterpretation, Documentation, and Follow-Up of Definitive Urine Drug Testing Results.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- Budget Impact Analysis of the Balanced Opioid Initiative: A Cluster Randomized Trial Aimed at Deprescribing Opioids for Chronic Pain in Primary Care Settings.Annals of family medicine · 2026Trial
- Urine methamphetamine-to-amphetamine ratio by LC-MS/MS to differentiate methamphetamine use from pharmaceutical impurity in patients prescribed amphetamine.Journal of mass spectrometry and advances in the clinical lab · 2025Article
- Article
- Clinician Ordering and Management Patterns of Urine Toxicology Results at a Cancer Center.Journal of pain and symptom management · 2024Article
- A Pharmacist-Led Process to Monitor Discrepant Urine Drug Screen Results.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty.Journal of medical biochemistry · 2023Article
- Comparing presumptive with direct-to-definitive drug testing in oral fluid vs. urine for a U.S. national sample of individuals misusing drugs.Drug and alcohol dependence · 2023Article
- Do Urine Drug Tests Reveal Substance Misuse Among Patients Prescribed Opioids for Chronic Pain?Journal of general internal medicine · 2022Article
- Opioid use disorder from poppy seed tea successfully treated with buprenorphine in primary care: a case report.Addiction science & clinical practice · 2021Article
- Implementing Best Practice When Screening Birthing People for a Substance Use Disorder.Journal of midwifery & women's healthArticle
- Toxicology Testing: Interpreting What That Number Means.Missouri medicineArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrine drug testing (UDT) is an essential tool to monitor opioid misuse among patients on chronic opioid therapy. Inaccurate interpretation of UDT can have deleterious consequences. Providers' ability to accurately interpret and document UDT, particularly definitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) results, has not been widely studied.
objectiveTo examine whether providers correctly interpret, document, and communicate LC-MS/MS UDT results.
designThis is a retrospective chart review of 160 UDT results (80 aberrant; 80 non-aberrant) between August 2017 and February 2018 from 5 ambulatory clinics (3 primary care, 1 oncology, 1 pain management). Aberrant results were classified into one or more of the following categories: illicit drug use, simulated compliance, not taking prescribed medication, and taking a medication not prescribed. Accurate result interpretation was defined as concordance between the provider's documented interpretation and an expert laboratory toxicologist's interpretation. Outcome measures were concordance between provider and laboratory interpretation of UDT results, documentation of UDT results, results acknowledgement in the electronic health record, communication of results to the patient, and rate of prescription refills. KEY
resultsAberrant results were most frequently due to illicit drug use. Overall, only 88 of the 160 (55%) had any documented provider interpretations of which 25/88 (28%) were discordant with the laboratory toxicologist's interpretation. Thirty-six of the 160 (23%) documented communication of the results to the patient. Communicating results was more likely to be documented if the results were aberrant compared with non-aberrant (33/80 [41%] vs. 3/80 [4%], p < 0.001). In all cases where provider interpretations were discordant with the laboratory interpretation, prescriptions were refilled.
conclusionsErroneous provider interpretation of UDT results, infrequent documentation of interpretation, lack of communication of results to patients, and prescription refills despite inaccurate interpretations are common. Expert assistance with urine toxicology interpretations may be needed to improve provider accuracy when interpreting toxicology results.
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