Ameritox

Why Monitor: Evaluating likely patient adherence through urine drug monitoring

With use of prescription opioids on the rise, it is increasingly important for clinicians to effectively manage the medication adherence of their chronic pain patients. The American Pain Society and American Academy of Pain Medicine guidelines for chronic opioid therapy state that “clinicians should consider periodically obtaining urine drug screens or other information” as part of their plan of care.1

Urine drug monitoring gives you critical information and insight to help you evaluate patient adherence to their pain medication regimen and help achieve better outcomes.

While most patients and physicians have the best intentions, a recent national study showed that, for a variety of reasons, many pain patients may not be using their pain medication properly. In the same study, more than 38% of the patients had no detectable level of their prescribed medications.2

There are numerous reasons for potential patient non-adherence 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, it is important to assess whether your chronic pain patients are adhering to their prescription regimens and taking their medications correctly. 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 patient 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 patient adherence to the COT plan of care (weak recommendation, low-quality evidence).”2

Improving Patient Adherence: 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 not 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 to assist with identifying possible issues with patient medication adherence.

Don’t take chances with your opioid patients. Trust Ameritox to help you monitor your patients on chronic opioid therapy. Request to speak to an Ameritox representative by filling out an online form or call us at (888) 494-2165.

References

1 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.

2Couto 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.

3 Turk, D, et al. Predicting opioid misuse by chronic pain patients. Clinical Journal of Pain. 2008. 24: 497-508.