Reducing Prescription Opioid Misuse and Abuse with Urine Drug Testing

年，慢性阿片类药物治疗慢性疼痛的使用大幅增加。 最近几年。随着阿片类药物使用的增加，随之而来的是 处方类阿片滥用和滥用。慢性阻塞性肺疾病临床实践指南 疼痛推荐尿药检(UDT)筛查处方阿片类药物滥用 患者在开始阿片类药物治疗之前，并在治疗期间定期。如果患者有异常 UDT结果应进行适当的随访。然而，只有不到25%的患者是 处方的慢性阿片类药物治疗接受UDT，并且没有关于如何获得经验数据 在UDT异常后，提供者改变了临床治疗。拟议的研究性研究将 采用混合研究方法研究UDT和管理虐待患者的方法 处方类阿片。这项建议的具体目的是：(1)在全国患者样本中， 估计UDT的发生率并确定与UDT的使用相关的变量，(2) 与临床医生进行定性访谈，以了解人们对UDT和 UDT结果异常患者的处理方法，以及(3)描述当前临床 练习遵循异常的UDT结果。这些结果将为更大规模的 旨在增加UDT使用并协助提供者管理的实施研究 UDT结果异常的患者。这项研究的长期目标是确保 安全使用和减少处方阿片类药物可预防的伤害。

The use of chronic opioid therapy for the treatment of chronic pain has increased dramatically in recent years. With the increase in the use of opioids, there has been a concomitant rise in prescription opioid misuse and abuse. Clinical practice guidelines for the treatment of chronic pain recommend screening for prescription opioid misuse with urine drug testing (UDT) for all patients prior to initiating opioid therapy and regularly during treatment. If patients have aberrant UDT results appropriate follow-up should ensue. However, less than 25% of patients who are prescribed chronic opioid therapy receive UDT and no empirical data are available about how providers alter clinical treatment following an aberrant UDT. The proposed research study will employ mixed research methods to study UDTs and methods for managing patients who abuse prescription opioids. The specific aims of this proposal are: (1) in a national sample of patients, estimate the incidence of UDT and identify variables associated with the use of UDT, (2) conduct qualitative interviews with clinicians to explore perceptions of barriers to UDT and methods for managing patients with aberrant UDT results, and (3) describe current clinical practice following an aberrant UDT result. These results will inform the development of a larger implementation study designed to increase the use of UDTs and assist providers in managing patients who have aberrant UDT results. The long-term goal of this research is to ensure the safe use and reduce preventable harm from prescription opioid medications.