Impact of urine drug screening on no shows and dropouts among chronic pain patients: A propensity-matched cohort study

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: The last 2 decades have seen a substantial increase in both the prescription of opioids for managing chronic pain, and an increase in opioid-related deaths in the US. Urine drug screening (UDS) is the de facto monitoring tool aimed at detecting and deterring opioid misuse. Objective: We study whether administering UDS on pain patients influences post-screening behavior of no-shows and dropouts. Study Design: Observational cohort study of electronic medical records. Setting: Single urban academic pain-clinic. Methods: A retrospective cohort comparison of patients receiving UDS versus those not receiving UDS was conducted on the entire sample as well as in the propensity score-matched samples in which matching was based on age, gender, pain-score, procedure-scheduled, systolic and diastolic blood pressure (BP), pulse, temperature, physician ID, year of visit, psychology referral, and opioid prescription in the first visit. In addition, we conducted within-subjects logistic-regression to study no-shows and non-proportional hazards survival modeling to study dropout. Results: Analyses of 4,448 clinic visits by 723 pain patients indicated that UDS exposure in the first visit is associated with increased risk of no-show in the second visit (OR = 2.73, P

Original languageEnglish (US)
Pages (from-to)89-100
Number of pages12
JournalPain Physician
Volume19
Issue number2
StatePublished - Feb 1 2016

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Keywords

  • Adherence
  • Chronic pain
  • Dropout
  • No-show
  • Opioid monitoring
  • Propensity-score matching
  • UDS
  • Urine-drug screening

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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