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. 2023 Nov 30;15(23):5663.
doi: 10.3390/cancers15235663.

Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic

John M Halphen  1 , Joseph A Arthur  2 , Soraira Pacheco  1 , Linh M T Nguyen  1 , Nikitha N Samy  3 , Nathaniel R Wilson  3 , Gregory Sattler  3 , Shane E Wing  3 , Rex A D Paulino  3 , Christine Feng  3 , Pulin Shah  3 , Simbiat Olayiwola  1 , Bradley Cannell  4 , Supriyanka Addimulam  4 , Riddhi Patel  4 , David Hui  2
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Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic

John M Halphen et al. Cancers (Basel). .

Abstract

Background: Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics.

Objectives: We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic.

Methods: A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results.

Results: Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03-4.38; p = 0.04), history of illicit drug use (OR = 3.57; CI: 1.78-7.13; p < 0.001), and history of marijuana use (OR = 7.05; CI: 3.85-12.91; p < 0.001) were independent predictors of an aberrant UDT finding.

Conclusion: Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings.

Keywords: cancer pain; education; immunoassay; nonmedical; opioid; palliative medicine; safety-net hospital; urine drug test.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Frequency of illicit substances present among patients with aberrant urine drug test at consultation (n = 100), within first 3 clinic visits (n = 125), and for all visits (n = 144).
See this image and copyright information in PMC

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References

    1. Childers J.W., King L.A., Arnold R.M. Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic. Am. J. Hosp. Palliat. Med. 2015;32:654–659. doi: 10.1177/1049909114531445. - DOI - PubMed
    1. Barclay J.S., Owens J.E., Blackhall L.J. Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen. Support. Care Cancer. 2014;22:1883–1888. doi: 10.1007/s00520-014-2167-6. - DOI - PubMed
    1. Starr T.D., Rogak L.J., Passik S.D. Substance Abuse in Cancer Pain. Curr. Pain Headache Rep. 2010;14:268–275. doi: 10.1007/s11916-010-0118-6. - DOI - PubMed
    1. Swedo E.A., Sumner S.A., de Fijter S., Werhan L., Norris K., Beauregard J.L., Montgomery M.P., Rose E.B., Hillis S.D., Massetti G.M. Adolescent Opioid Misuse Attributable to Adverse Childhood Experiences. J. Pediatr. 2020;224:102–109.e3. doi: 10.1016/j.jpeds.2020.05.001. - DOI - PMC - PubMed
    1. Merrick M.T., Ford D.C., Haegerich T.M., Simon T. Adverse Childhood Experiences Increase Risk for Prescription Opioid Misuse. J. Prim. Prev. 2020;41:139–152. doi: 10.1007/s10935-020-00578-0. - DOI - PMC - PubMed

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