Medication Monitoring: How Often – and How – Should You Test Patients?

Posted by Alex Metarelis on Jun 8, 2018 2:01:19 PM

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As a healthcare provider, it can be tough determining when to drug test patients. With the opioid epidemic in full swing and state medical boards shutting down clinics that fail to adequately monitor patients on controlled medication, the burden of drug testing loyal patients can put you between a rock and a hard place. 

Here are some recommended practices for medication monitoring based on prescribed regimen. 

Patients on Opioids & Opiates

Recommended: Every 1-3 Months

Patients prescribed triplicate medication are recommended to be tested monthly to quarterly. Patients who are high risk with a history of dependency should be tested every follow-up to ensure adherence to prescribed regimen and pinpoint attempted diversion. 

Brand names: OxyContin, Exalgo ER, Percocet, Lorcet, Norco, Vicodin, Subsys, Duragesic, Abstral, Utram, Duramorph, MS Contin, Dolophine, Methadose, Butrans, Subutex, Suboxone, Ritalin, Concerta, Adderall, Vyvanse

Generic names: Oxycodone, Oxymorphone, Hydrocodone, Fentanyl, Tramadol, Morphine, Methadone, Buprenorphine, Methylphenidate, Amphetamine

Patients on Controlled Medication

Recommended: Every 3 Months

This includes benzodiazepines and sleep medications. These drugs are often slept on – no pun intended – as they aren’t formally classified as opioids, nor do they fall within Schedule I-III categorization. They do, however, contribute a great deal to the current overdose crisis, as Xanax and Ambien appear frequently in drug cocktails and, when it’s too late, in an autopsy. 

Brand names: Xanax, Klonopin, Ativan, Valium, Ambien, Sonata, Lunesta

Generic names: Alprazolam, Clonazepam, Lorazepam, Diazepam, Zolpidem, Zaleplon, Eszopiclone

Patients on Antidepressants/Muscle Relaxants (SSRI & SSNI medications)

Recommended: Every 3-6 Months

his is primarily for patient safety and to ensure adherence to the prescribed dosage vs. accidentally overdosing because one pill feels less effective over time. Confirmatory testing urine would pinpoint the exact quantity of the drug and determine if the recommended amount is being taken as prescribed. 

Brand names: Zoloft, Cymbalta, Paxil, Prozac, Celexa, Flexeril, Soma

Generic names: Sertraline, Duloxetine, Paroxetine, Fluoxetine, Citalopram, Cyclobenzaprine, Carisoprodol

All New Patients

Recommended: On the first visit, before prescription

This is truly to establish a baseline. Painkiller or not, you need to know about an existing medication in a patient’s system before prescribing anything that could potentially cross-react and harm.

Three Testing Methodologies 

Like no other laboratory, Diax LabsTM offers three methodologies – urine, blood and saliva – for medication monitoring that reflect our commitment to exemplary drug testing standards. Our spectrum of laboratory test disciplines is accredited by the College of American Pathologists through its Laboratory Accreditation Program for adherence to the most scientifically rigorous customized checklist requirements.

Urine Drug Testing. Our urine drug testing methodology offers an extensive list of prescribed and/or illicit drugs in our menus and utilizes two methods – immunoassay and mass spectrometry – for the detection of drug use and misuse. 

EZ DropTM Blood Testing. Our proprietary single-drop blood test detects concentration levels of medications and the potential for drug interactions.

Saliva Testing. Our industry-leading clinical toxicology testing of saliva accurately confirms whether a patient is compliant with prescribed drug therapies.

By offering a comprehensive suite of urine, blood and saliva testing for medication monitoring, Diax LabsTM is a single resource for physicians to verify a patient’s usage compliance, adjust the treatment or terminate a drug therapy to protect the patient. 

Connecting the Dots with DNA LOCK™

Our revolutionary and proprietary DNA LOCKTM establishes a patient ID to confirm a genetic match or mismatch of future urine, blood and saliva samples. 

Our streamlined, five-step process also ensures consistent patient care by eliminating logistical issues for physicians and patients alike, both for safety during the global pandemic and for convenience once strict protocols are lifted. 

  1. A medical professional performs the DNA swab collection in the physician’s office or witnesses the collection via telemedicine.  
  2. Thereafter, a physician submits an online order for a patient urine, blood or saliva test.
  3. Diax Labs mails the collection kit directly to the patient. 
  4. The patient collects the urine, blood or saliva sample and returns it directly to Diax Labs in the provided postage-paid packaging. 
  5. Diax Labs reports a match or alerts a mismatch of the patient’s sample ID.

The Bottom Line

As healthcare providers, you have patients who have placed a great deal of trust in your care over the years. So, it may come as a surprise to your patient of 15 years when they’re recommended to take a urine drug test. But it may come as a bigger surprise when you discover this patient is taking both Xanax prescribed by you, Adderall obtained from their neighbor to stay focused through the day and also Soma because it helps them go to sleep at night. As a healthcare provider, you need to know this information to provide comprehensive care. 

There’s also a legal component associated with medication monitoring because it can provide an important layer of from potential legal exposure. Here’s why. Across the nation, federal and state governing bodies are revoking licenses and even administering jail time to healthcare providers who are prescribing controlled medication while not performing medication monitoring on their patients. 

As a service to the medical community, Diax LabsTM has developed clinical testing guidelines to keep you in full compliance, which you can download here:

Download Our Clinical Testing Guidelines

Here to Assist You 

If you are an independent physician or laboratory marketing professional that sells to these independent physicians, we welcome the opportunity to talk with you one on one about the range of urine, blood and saliva medication monitoring diagnostics available from Diax LabsTM. For more information or to schedule a virtual presentation, please click Learn More below.

Topics: Blog