Transcript Why Prescription Drug Monitoring?

Prescription Drug
Monitoring
Presented by:
Len Abbott, Ph.D. Director Science and Technology
Kathleen Valentine, General Manager PDM & Toxicology
May 14, 2015
Why Quest Diagnostics?
Drug
Testing
Expertise
Complete
Diagnostic
Menu
Resources
Total
Quest
Offering
Connectivity
Solutions
Health Plan
Access
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Over 60
Patient
Service
Centers in
VA
Why Prescription Drug
Monitoring?
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Misuse of Prescription Drugs
Prescription Drug Misuse Statistics
 1.4 million emergency department visits involved
nonmedical use of pharmaceuticals
 30% opioid analgesics
 36% anti-anxiety or insomnia medications
 Drug overdose deaths tripled since 1990
 Each day, 46 people die from an overdose of
prescription opioid or narcotic pain relievers
Source: CDC www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html and
www.cdc.gov/HomeandRecreationalSafety/pdf/PolicyImpact-PrescriptionPainkillerOD.pdf
www.cdc.gov/vitalsigns/
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Where and how are the drugs obtained?
Source of Prescription Pain Relievers
 The household medicine
cabinet is the primary source
of misuse
 Nearly 70% of people who
misuse prescription pain
medications are taking drugs
that were prescribed for
someone else
One Doctor
19.7%
Drug Dealer
3.9%
Internet
0.2%
Other
6.9%
Friend/Relative
68.9%
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.pdf
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Patients do not follow provider instructions…
Prescription Drug Monitoring Results Distribution
Quest Diagnostics January 2013 – December 2013
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What is the role of urine drug testing?
Urine Drug Testing is a part of a comprehensive drug monitoring
process:
Objective laboratory testing can help to:
 Identify prescription noncompliance, drug substitution or
supplementation
 Detect use of illegal substances
 Identify potential drug interaction
 Maintain patient access to beneficial prescription therapies
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Quest Diagnostics
Prescription Drug
Monitoring
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Quest Has Extensive Experience in Drug Testing
Prescription Drug Monitoring Program
 State of the art testing equipment
 Industry-leading technical expertise in LCMSMS technology
 Broad menu of testing for drugs and their
metabolites* –
Alcohol Metabolites
Amphetamines
Barbiturates
Benzodiazepines
Buprenorphine
Cocaine Metabolite
Fentanyl
Gabapentin
Heroin Metabolite
Marijuana Metabolite
MDMA/MDA
* Sample listing
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Meperidine
Methadone Metabolite
Methylphenidate
Opiates
Oxycodone
Phenocyclidine
Pregabalin
Propoxyphene
Synthetic Drugs
Tapentadol
Tramadol
Tricyclic Antidepressants
Quest Diagnostics performs
more than
10 million
drug tests annually
Drug Testing Process
Laboratory Testing
Positive Drug
Classes
Reflex to
Confirmation
if Ordered
Immunoassay
Qualitative Screen
1
2
Chemistry Instrumentation
• Testing at drug class
level
• Presumptive results
reported
(Positive/Negative)
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Mass
Spectrometry
Results
3
Positives Reflexed for
confirmation testing
• Uses alternate method
Confirmation performed
using Mass Spectrometry
• Metabolites identified
• Definitive results
reported
Prescription Drug Monitoring
PDM Product Offering
 Menu includes
 Chronic pain medications
 Companion controlled medications
 Substances of abuse
 Performance – Highly sensitive, low cut off levels
designed to detect drugs at typical dosage levels
 Reporting − medMATCH® Result Interpretation:
 “Consistent” when results match prescriptions
provided by physician
 “Inconsistent” when results do not match
prescriptions provided by physician
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medMATCH® Report
Prescribed
Medication(s)
Non-prescribed
medication(s)
Indicates
X Indicates
inconsistent
Consistent
medMATCH
Interpretation
Identifies
Inconsistent Results
Specimen Validity
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Q&A
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