Family physicians’ proficiency in urine drug test interpretation

Gary M. Reisfield, MD; Fern J. Webb, PhD; Roger L. Bertholf, PhD; Paul A. Sloan, MD; George R. Wilson, MD

doi:10.5055/jom.2007.0022

Authors

Gary M. Reisfield, MD
Fern J. Webb, PhD
Roger L. Bertholf, PhD
Paul A. Sloan, MD
George R. Wilson, MD

DOI:

https://doi.org/10.5055/jom.2007.0022

Keywords:

urine drug test, opioid, drug abuse

Abstract

Objective: To determine the proficiency in urine drug test interpretation among family medicine physicians who order these tests 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 administered to 80 family medicine physicians attending a University of Kentucky Family Medicine Review Course. We calculated frequencies and performed χ2 analyses to examine bivariate associations between urine drug test utilization and interpretive knowledge.
Results: The instrument was completed by 60/80 (75 percent) of eligible physicians (44 order urine drug testing; 16 do not). None of the physicians who order urine drug testing answered more than five of the seven questions correctly, and only 20 percent answered more than half correctly. Physicians who order urine drug testing performed better than physicians who do not order urine drug testing on only four of the seven questions, although there were no statistically significant differences between the groups on any question.
Conclusions: Family medicine physicians who order urine drug testing to monitor their patients on chronic opioid therapy are not proficient in their interpretation. This study highlights the need for improved physician education in this area. It is imperative for physicians to work closely with certified laboratory professionals when ordering and interpreting urine drug tests.

Author Biographies

Gary M. Reisfield, MD

Assistant Professor and Director, Division of Palliative Medicine, Department of Community Health & Family Medicine, University of Florida College of Medicine, Jacksonville, Florida.

Fern J. Webb, PhD

Assistant Professor, Department of Community Health & Family Medicine, University of Florida College of Medicine, Jacksonville, Florida.

Roger L. Bertholf, PhD

Associate Professor and Director, Division of Clinical Chemistry, Toxicology, and Point-of-Care Testing, Department of Pathology, University of Florida College of Medicine, Jacksonville, Florida.

Paul A. Sloan, MD

Professor, Department of Anesthesiology, University of Kentucky Medical Center, Lexington, Kentucky.

George R. Wilson, MD

Professor and Chairman, Department of Community Health & Family Medicine, University of Florida College of Medicine, Jacksonville, Florida.

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