title: Observations of medication compliance by measurement of urinary drug concentrations in a pain management population.
abstract: BACKGROUND
  One of the major concerns of physicians treating pain patients with opioids is to determine whether the patients are compliant, and this is commonly determined by urine drug testing. There is limited information on which drugs these patients are most compliant with. There is also limited information as to how compliance is defined in terms of cutoffs.
  
  
  OBJECTIVE
  To compare reported patient medication use with the presence of the drug in the patients' urine with defined cutoffs.
  
  
  METHODS
  A retrospective study of the medications listed by the physicians' offices and the confirmed drug test findings. A Millennium Laboratories database of 20, 457 patient results was examined for the presence of the listed medications and was matched for the presence of the drugs above the analytical cutoffs.
  
  
  RESULTS
  For oxycodone and hydrocodone, the authors observed 23 and 24 percent noncompliance, respectively. For carisoprodol, they observed 33 percent noncompliance. For morphine, they observed 14 percent noncompliance. For methadone, they observed 9 percent noncompliance.
  
  
  CONCLUSIONS
  Noncompliance is prevalent in this patient population and varies with the prescribed drug.
authors.affiliation: Millennium Laboratories, San Diego, California, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.forename: Amadeo
authors.initials: A
authors.lastname: Pesce
authors.forename: Cameron
authors.initials: C
authors.lastname: West
authors.forename: Bridgit
authors.initials: B
authors.lastname: Crews
authors.forename: Charles
authors.initials: C
authors.lastname: Mikel
authors.forename: Murray
authors.initials: M
authors.lastname: Rosenthal
authors.forename: Perla
authors.initials: P
authors.lastname: Almazan
authors.forename: Sergey
authors.initials: S
authors.lastname: Latyshev
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine*; D002328:Carisoprodol / Q000627:therapeutic use / Q000652:urine; D002853:Chromatography, Liquid; D019992:Databases as Topic; D006801:Humans; D006853:Hydrocodone / Q000627:therapeutic use / Q000652:urine; D055118:Medication Adherence; D008691:Methadone / Q000627:therapeutic use / Q000652:urine; D009020:Morphine / Q000627:therapeutic use / Q000652:urine; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D010098:Oxycodone / Q000627:therapeutic use / Q000652:urine; D010146:Pain / Q000188:drug therapy* / Q000652:urine*; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000379:methods / Q000592:standards; D053719:Tandem Mass Spectrometry
chemical_list: D000701:Analgesics, Opioid; D002328:Carisoprodol; D006853:Hydrocodone; D009020:Morphine; D010098:Oxycodone; D008691:Methadone