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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 STRATEGIESUrine Drug Testing in Clinical PracticeEdition 3, 2006
AUTHORSDouglas L. Gourlay, MD, FRCPC, FASAMThe Wasser Pain Management CentreMount Sinai HospitalToronto, Ontario CanadaYale H. Caplan, PhD, D-ABFTToxicologist Director, National Scientific ServicesBaltimore, MarylandNEEDS STATEMENTUrine drug testing in clinical practice should be a consensual diagnostic test, which is done with full explanation toand for the benefit of the patient. It can be used to provide objective documentation showing adherence to theagreed-upon treatment plan, to aid in the diagnosis and treatment of the disease of addiction or drug misuse, ifpresent, 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 clinicalsetting. The questions include the purpose of testing, which drugs to test for, the “best” sample to test, how tocollect the sample, which testing methods to use, and the level of understanding of the healthcare professionalsusing 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 theUDT in his or her clinical practice. A working relationship with your testing laboratory may be very helpful inaccurately interpreting UDT results.LEARNING OBJECTIVESAfter 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.GOALThe goal of this activity is to educate healthcare professionals on proper methods, uses, limitations, and evaluationof UDT results. This is in order to rationally employ testing in clinical practice to improve patient care, to protectone’s practice with objective documentation of adherence to the agreed-upon treatment plan, and to advocate forpatients as needed.ACCREDITATION STATEMENTThe California Academy of Family Physicians (CAFP) is accredited by the Accreditation Council for ContinuingMedical Education to provide continuing medical education for physicians.