Evidence map›Paper›PMID 33740362›Full record

ArticlePain physician2021

Trends in Urine Drug Monitoring Among Persons Receiving Long-Term Opioids and Persons with Opioid Use Disorder in the United States.

Minji Sohn, Jeffery C Talbert, Zhengyan Huang, Carrie Oser, Patricia R Freeman

Open access · bronzeAbstract read
In one paragraph

Article in Pain physician, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Minji SohnCollege of Pharmacy, Ferris State University, Big Rapids, MI.
Jeffery C TalbertDepartment of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY; Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, Lexington, KY.
Zhengyan HuangDepartment of Biostatistics, University of Kentucky College of Public Health, Lexington, KY.
Carrie OserDepartment of Sociology, University of Kentucky College of Arts and Sciences, Lexington, KY.
Patricia R FreemanDepartment of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY; Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, Lexington, KY.
Ferris State University · USUniversity of Kentucky · US

Funding

Doctor Shopping for Controlled Substances: Insights from Two-Mode Social Network AnalysisR01DA039928 · NIDA · TRUSTEES OF INDIANA UNIVERSITY · PI PERRY, BREA LOUISE · 2016 to 2019
$1.4M
NIDA NIH HHS R01 DA039928
6 · The paper itself

Abstract

backgroundPractice guidelines recommend urine drug monitoring (UDM) at least annually in the setting of chronic opioid therapy as an objective assessment of substance use. However, empirical evidence on who gets tested and how often testing occurs is lacking.

objectivesThis study investigates 10-year UDM trends in the United States based on 2 factors: (1) the duration of prescription opioid treatment, and (2) having an opioid use disorder (OUD) diagnosis and medications for opioid use disorder (MOUD) prescriptions. STUDY

designObservational cross-sectional study.

settingResearch was conducted using administrative claims data from Optum's deidentified Clinformatics Data Mart Database for the period 2007 to 2016. The dataset contained information on the plan enrollment and health care claims from 50 states and the District of Columbia.

methodsTo examine trends in UDM based on the duration of prescription opioid treatment, persons receiving prescription opioid analgesics were categorized into 4 groups based on the number of days covered: (a) less than 90 days, (b) 90 to 179 days, (c) 180 to 269 days, and (d) at least 270 days. To examine trends based on an OUD diagnosis and MOUD prescriptions, persons diagnosed with OUD were identified and categorized based on the presence of MOUD prescriptions as follows: (a) OUD with buprenorphine (BPN) and naltrexone (NTX) in the same year; (b) OUD with BPN only; (c) OUD with NTX only; (d) OUD with chronic prescription opioid analgesics (>= 90 days); (e) OUD without prescription opioid analgesics, BPN, or NTX; and (f) chronic prescription opioid analgesics (>= 90 days) without an OUD diagnosis. For analysis, the percent receiving UDM was estimated per group per year. Then the data were restricted to those receiving at least one UDM to estimate the average number of UDM per person.

resultsData included an average of 364,485 persons per year receiving prescription opioid analgesics for chronic use, and 10,277 per year receiving an OUD diagnosis. Among those receiving prescription opioid analgesics, less than 50% received UDM. For those receiving at least one UDM, one additional UDM was performed per person as the duration of opioids increased by 90 days. Among persons with OUD, the percent receiving UDM was the highest for those receiving both BPN and NTX (87%), followed by those receiving BPN only (80%), chronic opioids (79%), NTX only (72%), and those not receiving any MOUD/opioids (54%). LIMITATIONS: Methadone dispensing for OUD treatments was not captured in administrative claims data.

conclusionsAlthough recommended for patients with chronic pain, UDM is provided less than half of the time for these patients. However, once patients received at least one UDM, they would continue to receive it on a fairly regular basis. Compared with those with chronic pain, persons diagnosed with OUD are more likely to receive UDM at a more frequent interval.

Indexed as

AdultAnalgesics, OpioidBuprenorphineChronic PainCross-Sectional StudiesDrug MonitoringFemaleHumansMaleMethadoneMiddle AgedNaltrexoneOpioid-Related DisordersUnited StatesYoung AdultAnalgesics, OpioidBuprenorphineMethadoneNaltrexonebuprenorphinechronic painmedications for opioid use disordernaltrexoneopioid use disorderprescription opioid analgesicUrine drug monitoringurine drug screeningurine drug testing

Identifiers

PMID33740362
PMCPMC8195321
OpenAlexW3137949828

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.