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Observations of medication compliance by measurement of urinary drug concentrations in a pain management population

Robert West, MS, Amadeo Pesce, PhD, DABCC, Cameron West, PhD, Bridgit Crews, PhD, Charles Mikel, PhD, Murray Rosenthal, DO, FAPA, Perla Almazan, CLS, MT (ASCP), Sergey Latyshev, MS


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.
Method: 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.


pain patients, medication compliance, opioids, carisoprodol

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