Introduction to Complementary and Alternative Medicine

Hammett‐Stabler, Catherine A.

doi:10.1002/9780470910108.ch1

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Some patients may view physician requests for UDT as a punitive measure or as a disproportionate act of physician self-protection at the expense of optimal patient care [22]. Studies are needed to better determine the cost-effectiveness of these tests [36,37] because the financial [38,39] and logistic burden imposed on patients by conducting expensive tests may potentially cause psychological or emotional harm. It is difficult to determine the actual out-of-pocket cost of these tests, as they vary significantly depending on patient's geographic location, insurance policy, the laboratory used, and the facility where the test was ordered [40].…”

Section: Udt Application In Routine Clinical Carementioning

confidence: 99%

Urine Drug Testing in Cancer Pain Management

Arthur

2019

The Oncologist

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Urine drug test (UDT) is an effective tool used in chronic opioid therapy to ensure patient adherence to treatment and detect nonmedical opioid use. The two main types of UDT used in routine clinical practice are the screening tests or immunoassays and the confirmatory tests or laboratory‐based specific drug identification tests such as gas chromatography–mass spectrometry, liquid chromatography–mass spectrometry, or tandem mass spectrometry. UDT produces objective data on some nonmedical opioid use that may otherwise go undetected, such as the use of undisclosed medications, the nonuse of prescribed medications, and the use of illegal drugs. It allows clinicians to initiate an open and effective conversation about nonmedical opioid use with their patients. However, the test has certain limitations that sometimes compromise its use. Its interpretation can be challenging to clinicians because of the complexity of the opioid metabolic pathways. Clear guidelines or recommendations regarding the use of UDT in cancer pain is limited. As a result, UDT appears to be underused among patients with cancer pain receiving opioid therapy. More studies are needed to help standardize the integration and use of UDT in routine cancer pain management. Implications for Practice Despite its potential benefits, urine drug testing (UDT) appears to be underused among patients with cancer pain receiving opioid therapy. This is partly because its interpretation can be challenging owing to the complexity of the opioid metabolic pathways. Information regarding the use of UDT in opioid therapy among patients with cancer is limited. This review article will improve clinician proficiency in UDT interpretation and assist oncologists in developing appropriate treatment plans during chronic opioid therapy.

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Section: Udt Application In Routine Clinical Carementioning

confidence: 99%