New Guidance on the Use of Lab Testing to Monitor Pain Management Patients

The American Association of Clinical Chemistry released the practice guideline, "Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients," in the January issue of the Journal of Applied Laboratory Medicine. The committee says that while urine drug testing is regarded as the standard for adherence monitoring of patients taking controlled substances to manage chronic pain, test results are read and interpreted by distinctly different sets of individuals, including laboratory scientists and clinicians. The comprehensive guideline encompasses test use (laboratory and point-of-care [POC]) and results reporting and is based on both evidence-based recommendations and consensus-based expert opinion. The guideline addresses tests for relevant over-the-counter medications, prescribed and nonprescribed drugs, and illicit substances in pain management patients. Some of the more than 30 recommendations include: The three main tiers of testing (routine monitoring, testing of high-risk patients, and clinically needed testing) and classes of drugs to be tested should be based on risk, with more frequent laboratory testing recommended for patients with a personal or family history of substance abuse, mental illness, evidence of aberrant behavior, or other high-risk characteristics. Urine is the preferred specimen type for pain management drug testing, as the evidence supporting alternative matrices (e.g., saliva, […]