Urine toxicology screening among chronic pain patients on opioid therapy: Frequency and predictability of abnormal findings
Urine toxicology screening among chronic pain patients on opioid therapy: Frequency and predictability of abnormal findings
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DOI：
10.1097/ajp.0b013e31802b4f95
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发表时间：
2007-02-01
影响因子：
2.9
通讯作者：
Wasan, Ajay D.
中科院分区：
文献类型：
--
作者：
Michna, Edward;Jamison, Robert N.;Wasan, Ajay D.
目的：了解因疼痛而服用阿片类药物的慢性疼痛患者尿液毒理学筛查异常的发生率，并将这些结果与患者描述、阿片类药物的类型、数量和剂量联系起来。方法：回顾性分析470例在城市教学医院疼痛管理项目中进行尿液筛查的患者资料。采用气相色谱-质谱联用技术对尿样进行分析。患者的尿液筛查分为“正常”（根据处方药物的预期结果）和异常。异常结果是：(1)没有处方阿片类药物，(2)存在所有额外的非处方受控物质，(3)检测到非法物质，(4)尿样掺假。结果：45%的患者发现尿液筛查异常。20%的人被归类为尿液中含有非法物质。年轻患者比老年患者更频繁地发现非法物质和额外药物（P < 0.001）。没有发现其他变量预测异常尿液筛查结果。讨论：这些结果证实了过去的发现，在服用阿片类药物治疗疼痛的患者中，随机尿液毒理学筛查显示异常结果的发生率很高。常见的患者描述，处方阿片类药物的数量，类型和剂量被发现是异常结果的不良预测因子。
Objective: To examine the incidence of abnormal urine toxicology screening among chronic pain patients prescribed opioids for their pain and to relate these results to patient descriptors and type, number, and dose of prescribed opioids.Methods: A retrospective analysis of data from 470 patients who had urine screening at a pain management program in an urban teaching hospital was performed. Urine samples were analyzed using gas chromatography-mass spectrometry. Patients were categorized as having urine screens that were "normal" (expected findings based on their prescribed drugs) or abnormal. Abnormal findings were those of (1) absence of a prescribed opioid, (2) presence of all additional nonprescribed controlled substance, (3) detection of an illicit substance, and (4) an adulterated urine sample.Results: Forty-five percent of the patients were found to have abnormal urine screens. Twenty percent were categorized as having an illicit substance in their urine. Illicit substances and additional drugs were found more frequently in younger patients than in older patients (P < 0.001). No other variables were found to predict abnormal urine screen results.Discussion: These results confirm past findings that random urine toxicology screens among patients prescribed opioids for pain reveal a high incidence of abnormal findings. Common patient descriptors, and number, type, and dose of prescribed opioids were found to be poor predictors of abnormal results.