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171_UDT 2006 - Urine Drug Testing in Clinical Practice...

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Target Audience: Healthcare professionals who treat patients with pain. Sponsored by the California Academy of Family Physicians in cooperation with PharmaCom Group, Inc. This activity is supported by an unrestricted educational grant from Purdue Pharma L.P. There is no registration fee for this activity. DISPELLING THE MYTHS & DESIGNING STRATEGIES Urine Drug Testing in Clinical Practice Edition 3, 2006
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AUTHORS Douglas L. Gourlay, MD, FRCPC, FASAM The Wasser Pain Management Centre Mount Sinai Hospital Toronto, Ontario Canada Yale H. Caplan, PhD, D-ABFT Toxicologist Director, National Scientific Services Baltimore, Maryland NEEDS STATEMENT Urine drug testing in clinical practice should be a consensual diagnostic test, which is done with full explanation to and for the benefit of the patient. It can be used to provide objective documentation showing adherence to the agreed-upon treatment plan, to aid in the diagnosis and treatment of the disease of addiction or drug misuse, if present, and to advocate for the patient in family and social issues. Questions exist regarding which test to order and how to interpret a urine drug test (UDT) result in the clinical setting. The questions include the purpose of testing, which drugs to test for, the “best” sample to test, how to collect the sample, which testing methods to use, and the level of understanding of the healthcare professionals using the resulting data. Healthcare professionals must understand the strengths and limitations of any test, including the UDT, that may alter patient management. A healthcare professional should have a relationship of mutual honesty and trust with the patient when using the UDT in his or her clinical practice. A working relationship with your testing laboratory may be very helpful in accurately interpreting UDT results. LEARNING OBJECTIVES After completing this educational activity, participants should be better able to: 1. Clarify the purpose of urine drug testing and identify a clear testing strategy. 2. Distinguish between urine drug testing for detection of illicit drug use and for monitoring adherence to a treatment regimen. 3. Describe drug-testing methodology, instrumentation, and sensitivity/specificity of results. 4. Highlight strategies to improve: Analysis. Interpretation of results. 5. Understand the limitations of urine drug testing. GOAL The goal of this activity is to educate healthcare professionals on proper methods, uses, limitations, and evaluation of UDT results. This is in order to rationally employ testing in clinical practice to improve patient care, to protect one’s practice with objective documentation of adherence to the agreed-upon treatment plan, and to advocate for patients as needed. ACCREDITATION STATEMENT The California Academy of Family Physicians (CAFP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
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