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

doi:10.5055/jom.2010.0023

Authors

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

DOI:

https://doi.org/10.5055/jom.2010.0023

Keywords:

pain patients, medication compliance, opioids, carisoprodol

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.
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.

Author Biographies

Robert West, MS

Co-Laboratory Director, Millennium Laboratories, San Diego, California.

Amadeo Pesce, PhD, DABCC

Co-Laboratory Director, Millennium Laboratories, San Diego, California.

Cameron West, PhD

Executive Vice President, Millennium Laboratories, San Diego, California.

Bridgit Crews, PhD

Director Analytical Development, Millennium Laboratories, San Diego, California.

Charles Mikel, PhD

Chief Scientist, Millennium Laboratories, San Diego, California.

Murray Rosenthal, DO, FAPA

Medical Director, Millennium Laboratories, San Diego, California.

Perla Almazan, CLS, MT (ASCP)

Associate Director, Millennium Laboratories, San Diego, California.

Sergey Latyshev, MS

Staff Scientist, Millennium Laboratories, San Diego, California.

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