文章：

安全网缓和医疗诊所中接受阿片类药物治疗患者的免疫分析法尿液药物检测

Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic

原文发布日期：30 November 2023

DOI: 10.3390/cancers15235663

类型: Article

开放获取: 是

英文摘要：

Background: Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics. Objectives: We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic. Methods: A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results. Results: Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03–4.38;p= 0.04), history of illicit drug use (OR = 3.57; CI: 1.78–7.13;p< 0.001), and history of marijuana use (OR = 7.05; CI: 3.85–12.91;p< 0.001) were independent predictors of an aberrant UDT finding. Conclusion: Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings.

摘要翻译： 

背景：目前较少有研究探讨安宁疗护门诊中癌症患者的免疫分析法尿液药物检测应用情况。目的：本研究旨在分析安全网医院安宁疗护门诊中免疫分析法尿液药物检测异常结果的发生频率及其相关因素。方法：对2015年9月1日至2020年12月31日期间，在资源有限的安全网医院系统门诊安宁疗护科连续就诊的合格患者电子病历进行回顾性分析。收集患者人口统计学特征、尿液药物检测结果及潜在异常结果预测因素的纵向数据。结果：在913例研究患者中，500例（55%）接受了尿液药物检测，其中455例（50%）在前三次就诊期间完成检测。在前三次就诊期间接受检测的患者中，125例（27%）出现异常检测结果；其中44例（35%）可卡因检测呈阳性。通过多变量回归模型分析前三次就诊期间异常尿液药物检测结果的预测因素，非西班牙裔白人种族（比值比=2.13；95%置信区间：1.03-4.38；p=0.04）、非法药物使用史（比值比=3.57；置信区间：1.78-7.13；p<0.001）和大麻使用史（比值比=7.05；置信区间：3.85-12.91；p<0.001）是异常尿液药物检测结果的独立预测因素。结论：尽管免疫分析法尿液药物检测存在局限性，但在安全网医院安宁疗护门诊就诊的大量患者中，该方法仍能检测出异常用药行为（包括可卡因使用）。这些发现支持在资源有限环境下实施普遍性尿液药物监测，并证实基于免疫分析法的尿液药物检测具有实用价值。

原文链接：

Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic