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

Authors

John M Halphen
Joseph A Arthur
Soraira Pacheco
Linh M T Nguyen
Nikitha N Samy
Nathaniel R Wilson
Gregory Sattler
Shane E Wing
Rex A D Paulino
Christine Feng
Pulin Shah
Simbiat Olayiwola
Bradley Cannell
Supriyanka Addimulam
Riddhi Patel
David Hui

Language

English

Publication Date

11-30-2023

Journal

Cancers

DOI

10.3390/cancers15235663

PMID

38067365

PMCID

PMC10705126

PubMedCentral® Posted Date

November 2023

PubMedCentral® Full Text Version

Post-print

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;

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

Published Open-Access

yes

Recommended Citation

Halphen, John M; Arthur, Joseph A; Pacheco, Soraira; et al., "Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic" (2023). Faculty, Staff and Student Publications. 652.
https://digitalcommons.library.tmc.edu/uthmed_docs/652