Urine drug test interpretation: what do physicians know?
OBJECTIVE
To determine the level of urine drug test (UDT) interpretive knowledge of physicians who use these instruments to monitor adherence in their patients on chronic opioid therapy.


METHODS
A seven-question instrument consisting of six five-option, single-best-answer multiple choice questions and one yes/no question was completed by 114 physicians (77 who employ UDT and 37 who do not) attending one of three regional opioid education conferences. We calculated frequencies and performed chi2 analyses to examine bivariate associations between UDT utilization and interpretive knowledge.


RESULTS
The instrument was completed by 80 percent of eligible respondents. None of the physicians who employ UDT answered all seven questions correctly, and only 30 percent answered more than half correctly. Physicians who employ UDT performed no better on any of the questions than physicians who do not employ UDT.


CONCLUSIONS
Physicians who employ UDT to monitor patients receiving chronic opioid therapy are not proficient in test interpretation. This study highlights the need for improved physician education; it is imperative for physicians to work closely with certified laboratory professionals when ordering and interpreting these tests.
Reisfield
Gary M
GM
Department of Community Health & Family Medicine, University of Florida College of Medicine-Jacksonville, USA.
Bertholf
Roger
R
Barkin
Robert L
RL
Webb
Fern
F
Wilson
George
G
D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use / Q000652:urine*; D001711:Biotransformation; D002983:Clinical Competence; D003061:Codeine / Q000652:urine; D013759:Dronabinol / Q000652:urine; D016903:Drug Monitoring / Q000379:methods*; D005188:False Negative Reactions; D007722:Health Knowledge, Attitudes, Practice; D003932:Heroin / Q000652:urine; D006556:Heroin Dependence / Q000175:diagnosis / Q000652:urine; D006801:Humans; D004091:Hydromorphone / Q000652:urine; D008385:Marijuana Smoking / Q000652:urine; D009020:Morphine / Q000652:urine; D009021:Morphine Dependence / Q000175:diagnosis / Q000652:urine; D010207:Papaver; D010865:Pilot Projects; D028321:Plant Preparations / Q000652:urine; D011237:Predictive Value of Tests; D012639:Seeds; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D028321:Plant Preparations; D003932:Heroin; D009020:Morphine; D013759:Dronabinol; D004091:Hydromorphone; D003061:Codeine