scholarly journals Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

2021 ◽  
Vol 8 ◽  
pp. 237437352110331
Author(s):  
Alexa Brett ◽  
Heather Foster ◽  
Michael Joseph ◽  
Jill S. Warrington
Keyword(s):  
Substance Use ◽  
Best Practices ◽  
Substance Use Disorder ◽  
Drug Testing ◽  
Care Delivery ◽  
Patient Centered ◽  
Barriers To Access ◽  
Patient Satisfaction Scores ◽  
Urine Drug Testing ◽  
Urine Drug

Patients with substance use disorder (SUD) rely upon urine drug testing to support treatment adherence and to mitigate relapse. Before the onset of coronavirus 2019 (COVID-19), the logistical challenges of randomized observed collections for urine drug testing for the patient were significant. During COVID-19, these barriers were often insurmountable. Since SUD patients represent a population at a higher risk for complications from COVID-19, an alternative strategy to support COVID-19 testing was urgently needed. We designed and deployed a telehealth-based solution in which patients could use mobile devices to connect with trained collection professionals to perform observed urine collections, often referred to a UA (urinalysis). The solution was designed with patient-centered best practices for telehealth, stigma prevention, trauma-informed, empathy and compassion, and to remove barriers to access to care. This approach demonstrated high patient satisfaction scores thereby proving that it is possible to provide urine collection services in the patient’s home via a telehealth technology, while still upholding SUD testing integrity best practices. This study lays the path for a more patient-centered way to support this population.

scholarly journals Driving Access to Care: Use of Mobile Units for Urine Specimen Collection During the Coronavirus Disease-19 (COVID-19) Pandemic

2020 ◽  
Vol 7 ◽  
pp. 237428952095355
Author(s):  
Jill S. Warrington ◽  
Alexa Brett ◽  
Heather Foster ◽  
Jamie Brandon ◽  
Samuel Francis-Fath ◽  
...  
Keyword(s):  
Substance Use ◽  
Access To Care ◽  
Substance Use Disorder ◽  
Drug Testing ◽  
Geographic Region ◽  
Urine Specimen ◽  
Mobile Unit ◽  
Increased Risk ◽  
Urine Drug Testing ◽  
Urine Drug

Patients with substance use disorders (SUD) are at increased risk of both coronavirus disease-19 complications as well as exacerbations of their current conditions due to social distancing and isolation. Innovations that provide increased access to support substance use disorder patients may mitigate long-term sequelae associated with continued or renewed drug use. To improve patient access during the coronavirus disease-19 pandemic, we deployed a mobile unit to enable access to urine drug testing where needed for patients suffering from substance use disorder. Over a 3-week pilot program, 54 patients received urine drug testing across 5 providers and 8 zip codes. The mobile unit was cost-effective, demonstrating a volume-dependent 19% lower cost compared to pre-coronavirus disease-19 patient service centers in a similar geographic region. The mobile unit was well-received by patients and providers with an average of 9 out of 10 satisfaction scores and allowed for access to urine drug testing for 67% patients who would not have received testing during this time frame. No statistically significant differences were found in substance use positivity rates in comparison to pre-coronavirus disease findings; however, some shifts in use included higher rates of fentanyl and opioid positivity and reductions in tetrahydrocannabinol and cocaine use in the mobile collections setting. Deployment of mobile collection services during the coronavirus disease-19 pandemic has shown to be an effective mechanism for supporting patients suffering from substance use disorder, allowing for access to care of this often stigmatized, vulnerable population.

scholarly journals Urine Drug Testing: Current Recommendations and Best Practices

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. ES119-ES133
Author(s):  
Allen W. Burton
Keyword(s):  
Chronic Pain ◽  
Best Practices ◽  
Drug Testing ◽  
Point Of Care ◽  
Treatment Plan ◽  
Management Strategies ◽  
The United States ◽  
Enzyme Linked Immunosorbent Assay ◽  
Urine Drug Testing ◽  
Urine Drug

Background: The precise role of urine drug testing (UDT) in the practice of pain medicine is currently being defined. Confusion exists as to best practices, and even to what constitutes standard of care. A member survey by our state pain society revealed variability in practice and a lack of consensus. Objective: The authors sought to further clarify the importance of routine UDT as an important part of an overall treatment plan that includes chronic opioid prescribing. Further, we wish to clarify best practices based on consensus and data where available. Methods: A 20-item membership survey was sent to Texas Pain Society members. A group of chronic pain experts from the Texas Pain Society undertook an effort to review the best practices in the literature. The rationale for current UDT practices is clarified, with risk management strategies outlined, and recommendations for UDT outlined in detail. A detailed insight into the limitations of point-of-care (enzyme-linked immunosorbent assay, test cups, test strips) versus the more sensitive and specific laboratory methods is provided. Limitations: Our membership survey was of a limited sample size in one geographic area in the United States and may not represent national patterns. Finally, there is limited data as to the efficacy of UDT practices in improving compliance and curtailing overall medication misuse. Conclusions: UDT must be done routinely as part of an overall best practice program in order to prescribe chronic opioid therapy. This program may include risk stratification; baseline and periodic UDT; behavioral monitoring; and prescription monitoring programs as the best available tools to monitor chronic opioid compliance. Key words: Urine drug screening, urine toxicology screening, urine drug testing, chronic pain, addiction, forensic testing

Using urine drug testing to support healthy boundaries in clinical care

2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Howard A. Heit, MD, FACP, FASAM ◽  
Douglas L. Gourlay, MD, MSc, FRCPC, FASAM
Keyword(s):  
Chronic Pain ◽  
Risk Management ◽  
Management Strategy ◽  
Drug Testing ◽  
Clinical Care ◽  
Risk Management Strategy ◽  
Patient Centered ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Common Barriers

Risk management is first and foremost about protecting patients. This article will examine risk management in general, and urine drug testing (UDT) in particular, as core constituents in an effective, comprehensive risk management strategy. The article will explore UDT as a tool to help practitioners and patients make better choices in the clinical management of chronic pain. How one makes these difficult clinical decisions based on UDT results as well common barriers encountered in conducting patient-centered UDT will also be examined.

Analytical and technical aspects of testing for drug abuse: confirmatory procedures.

1988 ◽  
Vol 34 (3) ◽  
pp. 471-473 ◽  
Author(s):  
M A Peat
Keyword(s):  
Drug Testing ◽  
Analytical Procedure ◽  
Gas Chromatography Mass Spectrometry ◽  
Technical Aspects ◽  
Governmental Agencies ◽  
Accuracy And Precision ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chemical Technique ◽  
Layer Chromatography

Abstract Many laboratories are now performing urine drug testing for employers, governmental agencies, and other institutions. It is now recognized that presumptive positive screening results have to be confirmed by an analytical procedure based on a different chemical technique with greater than or equal sensitivity to the screening test. Thin-layer chromatography has been widely used for this; however, it is relatively insensitive for certain drugs, and it cannot satisfy the accuracy and precision requirements needed to determine threshold concentrations reliably. Gas chromatography-mass spectrometry is able to satisfy these threshold requirements and has become the method of choice for confirming initial immunoassay results.

Use of LC-HRMS in full scan-XIC mode for multi-analyte urine drug testing - a step towards a ‘black-box’ solution?

2017 ◽  
Vol 52 (8) ◽  
pp. 497-506 ◽  
Author(s):  
N. N. Stephanson ◽  
P. Signell ◽  
A. Helander ◽  
O. Beck
Keyword(s):  
Drug Testing ◽  
Black Box ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Full Scan
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