urine drug screen testing (UDS)
Therapeutic drug monitoring has become a useful tool to help protect both patients and providers. Qualitative testing, or point-of-care (POC) only shows positive or negative results for a drug; an incomplete result. Specific drugs are not targeted while false negatives and false positives are very common as the testing is not precise. Quantitative testing, or definitive testing (confirmation) offers a comprehensive outlook as it uses an analytical methodology; liquid chromatography–mass spectrometry (LC-MS). It shows the chemical signature of each drug which produces the specific concentration levels through the metabolite build up.
why to test
protects providers
prevents patient abuse
frequent confirmation testing is a no-brainer as Medicare covers nine tests a year
who to test
patients prescribed to controlled substances
patients with multiple subscribers
patients with absence of prescriptions
patients at clinics close to state lines
patients new to a practice to establish a baseline
patients with a psychiatric disorder/history of mental illness
patients with a history of drug abuse/alcoholism
when to test
when patients have unusual behavior
regularly while patients are taking controlled substances (once a month)
if patients have multiple prescribers/pharmacies/overlapping prescriptions
if patients have changes in treatment plans/therapy
