Urine drug screen findings among ambulatory oncology patients in a supportive care clinic

Purpose Professional organizations provide no guidelines regarding assessment and management of opioid abuse risk in cancer. Universal precautions (UP) developed for non-cancer pain, include assessments for aberrant behavior, screening questionnaires, and urine drug screens (UDS). The role of UDS fo...

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Bibliographic Details
Published in:Supportive care in cancer 2017-06, Vol.25 (6), p.1859-1864
Main Authors: Rauenzahn, Sherri, Sima, Adam, Cassel, Brian, Noreika, Danielle, Gomez, Teny Henry, Ryan, Lynn, Wolf, Carl E., Legakis, Luke, Del Fabbro, Egidio
Format: Article
Language:English
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Summary:Purpose Professional organizations provide no guidelines regarding assessment and management of opioid abuse risk in cancer. Universal precautions (UP) developed for non-cancer pain, include assessments for aberrant behavior, screening questionnaires, and urine drug screens (UDS). The role of UDS for identifying opioid abuse risk in cancer is uncertain. Our aim is to characterize inappropriate UDS, and identify a potential role for UDS in therapeutic decision-making. Methods An observational retrospective chart review of 232 consecutive supportive care clinic patients were seen during the study. Twenty-eight of the two hundred thirty-two did not meet inclusion criteria. One hundred fifty of the two hundred four had active cancer, while 54 had no evidence of active disease. Clinicians ordered UDS based on their clinical judgment of patients’ substance misuse risk. Edmonton symptom assessment scores, history of substance abuse, alcohol use, tobacco use, aberrant behavior, and morphine equivalent daily dose (MEDD) were obtained. Results Pain scores and MEDD were higher ( p  = 0.021; p  
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-017-3575-1