TY - JOUR
KW - Analgesics, Opioid/adverse effects/therapeutic use
KW - Guideline Adherence
KW - Humans
KW - Opioid-Related Disorders/etiology/prevention & control/urine
KW - Pain/complications/drug therapy/urine
KW - Practice Guidelines as Topic
KW - Substance Abuse Detection/standards
KW - United States
KW - Urinalysis/standards
AU - J. F. Peppin
AU - S. D. Passik
AU - J. E. Couto
AU - P. G. Fine
AU - P. J. Christo
AU - C. Argoff
AU - G. M. Aronoff
AU - D. Bennett
AU - M. D. Cheatle
AU - K. A. Slevin
AU - N. I. Goldfarb
A1 - 
AB - OBJECTIVE: Several prominent guidelines recommend that patients on long-term opioid therapy have periodic urine drug monitoring (UDM) for appropriate use; however, none address the specific questions of which patients to test, which substances to test for, how often to test, and how to act on the results. DESIGN: In the absence of adequate scientific evidence in the literature, a panel of experts in the field of pain and addiction medicine was convened to develop consensus UDM recommendations. The panel met three times between March 2010 and April 2011, and reviewed several drafts of the recommendations document between meetings. RESULTS: The group was able to achieve consensus on a set of UDM recommendations addressing test selection, test frequency, interpretation of results, and how to handle discrepancies based on specific results. CONCLUSION: While the participating panel members recognize that there currently is a limited evidence base to support the expert panel's recommendations, primary care providers and pain specialists are largely acting today based on anecdote, intuition, and individual experience. The recommendations are meant to begin to provide a framework for standardizing practices for UDM in the treatment of chronic pain, and to serve as a catalyst to advance research that quantifies the effects of UDM on opioid therapy management and patient outcomes.
BT - Pain medicine (Malden, Mass.)
C5 - Opioids & Substance Use; Education & Workforce
CP - 7
CY - England
DO - 10.1111/j.1526-4637.2012.01414.x
IS - 7
JF - Pain medicine (Malden, Mass.)
N2 - OBJECTIVE: Several prominent guidelines recommend that patients on long-term opioid therapy have periodic urine drug monitoring (UDM) for appropriate use; however, none address the specific questions of which patients to test, which substances to test for, how often to test, and how to act on the results. DESIGN: In the absence of adequate scientific evidence in the literature, a panel of experts in the field of pain and addiction medicine was convened to develop consensus UDM recommendations. The panel met three times between March 2010 and April 2011, and reviewed several drafts of the recommendations document between meetings. RESULTS: The group was able to achieve consensus on a set of UDM recommendations addressing test selection, test frequency, interpretation of results, and how to handle discrepancies based on specific results. CONCLUSION: While the participating panel members recognize that there currently is a limited evidence base to support the expert panel's recommendations, primary care providers and pain specialists are largely acting today based on anecdote, intuition, and individual experience. The recommendations are meant to begin to provide a framework for standardizing practices for UDM in the treatment of chronic pain, and to serve as a catalyst to advance research that quantifies the effects of UDM on opioid therapy management and patient outcomes.
PP - England
PY - 2012
SN - 1526-4637; 1526-2375
SP - 886
EP - 896
EP - 
T1 - Recommendations for urine drug monitoring as a component of opioid therapy in the treatment of chronic pain
T2 - Pain medicine (Malden, Mass.)
TI - Recommendations for urine drug monitoring as a component of opioid therapy in the treatment of chronic pain
U1 - Opioids & Substance Use; Education & Workforce
U2 - 22694154
U3 - 10.1111/j.1526-4637.2012.01414.x
VL - 13
VO - 1526-4637; 1526-2375
Y1 - 2012
ER -