Lacking evidence for the association between frequent urine drug screening and health outcomes of persons on opioid agonist therapy |
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| Institution: | 1. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada;2. Oregon Health & Science University (OHSU)-Portland State University (PSU) School of Public Health, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States;3. OHSU MD-PhD Program, School of Medicine, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States;4. Department of Medicine, University of British Columbia, St. Paul''s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada;5. School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland;1. Department of Medicine, Division of Infectious Diseases, Emory University, 341 Ponce de Leon Avenue, Atlanta, GA 30308, USA;2. Department of Medicine, Division of General Internal Medicine and Geriatrics, Emory University, 49 Jesse Hill Drive SE #40, Atlanta, GA 30303, USA;3. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center; 801 Massachusetts Avenue, CT 2, Boston, MA 02118, USA;4. Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, CT 2, Boston, MA 02118, USA;1. Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, United States;2. Boston University School of Public Health, Department of Biostatistics, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, United States;3. Boston University School of Public Health, Data Coordinating Center, 85 East Newton St., M921, Boston, MA 02118, United States;4. Boston University School of Medicine, 72 East Concord St. Boston, MA 02118, United States;5. Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Avenue, Boston, MA 02118, United States;1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA;2. Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA;3. Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA;4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand;5. Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA;1. Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, United States;2. Behavioral and Urban Health Program, RTI International, 351 California St., San Francisco, CA, United States;3. Department of Psychiatry and Biobehavioral Sciences, UCLA Center for Social Medicine and the Humanities, Semel Institute, 760 Westwood Plaza, Los Angeles, CA, United States;1. Norwegian Centre for Addiction Research, Institute for Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway;2. proLAR, Rådhusveien 26, 4640 Søgne, Norway |
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| Abstract: | BackgroundOpioid agonist therapy (OAT) is a first-line treatment for opioid use disorder (OUD); however, the efficacy and role of urine drug screening (UDS) in OAT has received little research attention. Prior evidence suggests that UDS frequency reflects philosophy and practice context rather than differences in patient characteristics or clinical need. Therefore, we reviewed the literature on the effect of and recommendations for the frequency of UDS on health outcomes for persons with OUD who receive OAT.MethodsWe searched Medline and EMBASE for articles published from 1995-2017. Search results underwent double, independent review with discrepancies resolved through discussion with a third reviewer, when necessary. Additional articles were identified through snowball searching, hand searching (Google Scholar), and expert consultation. The Cochrane tool was used to assess risk of bias.ResultsOf the 60 potentially eligible articles reviewed, only one three-arm randomized open-label trial, comparing weekly and monthly UDS testing with take-home OAT doses, met our inclusion criteria.ConclusionsOur review identified an urgent gap in research evidence underpinning an area of clinical importance and that is routinely reported by patients as an area of concern. |
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| Keywords: | urine drug screening urinalysis office-based opioid treatment opioid agonist treatment hospitalization substance-related disorders |
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