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- W2004983467 abstract "Due to either intentional or unintentional misreporting, obtaining an accurate medication and substance abuse history from a patient in order to safely and effectively manage pain is difficult. We tested the hypothesis that by combining results of a patients' self-reported history, medical records, and 10 class point of care urine drug screen sample, we could calculate a modified inconsistency score and identify patients at risk for abnormal drug-taking behavior. We approached 94 patients who had a chief complaint of pain and presented to the Emergency Department at the University of Virginia between June and August 2011. 53 patients agreed to participate, 52 of whom provided a urine sample. 44% declined to participate. 80% of participants had a negative UDS for drugs that were either reported (52%) or prescribed (28%). 82% of participants had a positive UDS for drugs that were either not listed in their patient questionnaire (50%) or not prescribed (32%). Of the inappropriately positive UDS, opioids were most likely to not be reported 33% of the time, while both opioids and benzodiazepines were most likely to not have been prescribed, 28% and 19% of the time respectively. Marijuana use had the highest correlation between self report and UDS results (71%) while opiate use had the lowest (10%). The average MIS amongst those who were UDS positive was 2.35 (range 0-5), while the average MIS amongst those who were UDS negative was 0.68 (range of 0-4). 72% of the UDS positive patients had a MIS of 2 or higher; 21% had a MIS of 4 or higher. 83% of the UDS negative patients had a MIS of 1 or less. A large percentage of patients presenting to the emergency department misreported their medication and/or substance abuse history. Aberrant drug-taking behavior strongly correlated with higher average MIS. Due to either intentional or unintentional misreporting, obtaining an accurate medication and substance abuse history from a patient in order to safely and effectively manage pain is difficult. We tested the hypothesis that by combining results of a patients' self-reported history, medical records, and 10 class point of care urine drug screen sample, we could calculate a modified inconsistency score and identify patients at risk for abnormal drug-taking behavior. We approached 94 patients who had a chief complaint of pain and presented to the Emergency Department at the University of Virginia between June and August 2011. 53 patients agreed to participate, 52 of whom provided a urine sample. 44% declined to participate. 80% of participants had a negative UDS for drugs that were either reported (52%) or prescribed (28%). 82% of participants had a positive UDS for drugs that were either not listed in their patient questionnaire (50%) or not prescribed (32%). Of the inappropriately positive UDS, opioids were most likely to not be reported 33% of the time, while both opioids and benzodiazepines were most likely to not have been prescribed, 28% and 19% of the time respectively. Marijuana use had the highest correlation between self report and UDS results (71%) while opiate use had the lowest (10%). The average MIS amongst those who were UDS positive was 2.35 (range 0-5), while the average MIS amongst those who were UDS negative was 0.68 (range of 0-4). 72% of the UDS positive patients had a MIS of 2 or higher; 21% had a MIS of 4 or higher. 83% of the UDS negative patients had a MIS of 1 or less. A large percentage of patients presenting to the emergency department misreported their medication and/or substance abuse history. Aberrant drug-taking behavior strongly correlated with higher average MIS." @default.
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- W2004983467 date "2012-04-01" @default.
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- W2004983467 title "Using multi-modal information to identify patients at risk for abnormal drug-taking behavior presenting to the emergency department" @default.
- W2004983467 doi "https://doi.org/10.1016/j.jpain.2012.01.043" @default.
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