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General Inquiries:
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300 E. Lombard Street
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Baltimore, MD 21202
(888) 494-2165
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9930 West Highway 80
Midland, Texas 79706
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Why Monitor
With urine drug monitoring, you obtain the critical information and insight to help you evaluate your patients’ pain medication use and achieve better outcomes.
Effective pain therapy requires more than choosing the right drugs for your patients. You also need to be confident and assured that your patients are adhering to their prescribed regimens. Pain medication monitoring provides that insight—and helps you evaluate whether chronic pain patients are using their medications as prescribed. Monitoring also helps to identify medications you may not have prescribed or illicits.
While most patients and physicians have the best intentions, a recent national study showed that 75% of the patients in the study may not be taking their pain medications in a manner that is consistent with their prescribed regimens. In the same study, more than 38% of the patients had no detectable level of their prescribed medications, and 42% had drug levels above or below the expected levels.1
There are numerous reasons why patients may not adhere to their prescription regimens. For example, patients may:
- Choose not to take their medication regularly due to fear of addiction.
- Take too little medication, or none at all, because of the costs or side effects.
- Take too much medication because of inadequate pain control or addiction.
- Divert their pain medications – whether unintentionally or intentionally.
In order to reduce medication misuse and abuse, you need to know that every one of your chronic pain patients is taking his or her medication as prescribed. It’s vital information for assuring that your patients receive the right treatment for the best outcomes—and protecting the safety of both your patients and your practice.
“By themselves, provider ‘intuition,’ patient self-reports, observation, prior documented history, and urine toxicology screens are inadequate. Rather, multiple sources of information are required to obtain the best estimate of risk potential.” — Dennis C. Turk, PhD, Professor of Anesthesiology and Pain Research at the University of Washington
In the “Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Patients,” the American Pain Society and American Academy of Pain Medicine recommends the following:
- In patients on chronic opioid therapy (COT) who are at high risk or who have engaged in aberrant drug-related behaviors, clinicians should periodically obtain urine drug screens or other information to confirm adherence to the COT plan of care (strong recommendation, low-quality evidence).
- In patients on COT not at high risk or not known to have engaged in aberrant drug-related behaviors, clinicians should consider periodically obtaining urine drug screens or other information to confirm adherence to the COT plan of care (weak recommendation, low-quality evidence).2
Pain Medication Monitoring Reveals Opportunities for Better Outcomes
Pain medication monitoring solutionsSM provide physicians with a more complete picture of each chronic pain patient’s medication use. This information allows physicians and their patients to discuss whether:
- A patient is experiencing a change in symptoms.
- An additional medication was prescribed by another provider.
- A patient is taking medication “as needed,” routinely, or at all.
- A patient is taking potentially dangerous illicits.
- A patient is bingeing or hoarding medication.
In addition to helping patients avoid dangerous consequences of pain medication misuse, pain medication monitoring is also critical in identifying those chronic pain patients who may be diverting their pain medications. For all of these reasons, physicians should develop a regular monitoring program for all patients on chronic opioid therapy.
Notes
1Couto JE, Goldfarb NI, Leider HL, Romney MC, Sharma S. High rates of inappropriate drug use in the chronic pain population. Popul Health Manag. 2009;12(4):185–190.
2 Chou R, Fanciullo GJ, Fine PG. et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–130.
