MedicalResearch.com Interview with:
F. Leland McClure III, MSci, PhD, F-ABFT
Medical science liaison director
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many physicians associate Quest Diagnostics with their lab service needs because of our leadership in laboratory testing. But Quest is more than a lab, which is why we refer to ourselves as a diagnostic information services provider. This means that we help providers, health plans and even patients use the insights we derive from our lab testing data to deliver better care, quality and outcomes, both for the patient and the managed population.
Our 2016 Quest Diagnostics Health Trends(TM) Prescription Drug Monitoring Report is an example of how we provide important health insights from Quest’s laboratory data. Prescription drug misuse is a major epidemic in the United States. Laboratory testing can help identify if a patient is using or misusing prescribed medications. For instance, lab tests can show evidence of additional medications and other drugs in a patient’s urine specimen, suggesting potentially dangerous drug combinations. Earlier this year, the CDC issued guidelines that call for laboratory testing for patients prescribed certain medications, such as opioids, that carry a risk of abuse.
Quest’s prescription drug monitoring services help the physician identify if a patient is taking or not taking up to about four dozen drugs, such as oxycodone, Adderall XR® and Percocet®. For the Quest analysis, we analyzed more than 3 million de-identified lab test results.
In this report, we found that 54 percent of patients’ results tested in 2015 showed evidence of drug misuse, slightly above the 53 percent misuse rate in 2014. That is certainly unacceptably high, but it’s a significant decline from the high of 63 percent we observed in 2011.
We also found that an increasing proportion of patients who misuse medications combine their prescription medication with non-prescribed drugs. Among patients with inconsistent test results, forty-five percent of these patients showed evidence of one or more other drug(s) in addition to their prescribed drug regimen. That’s much higher than our findings of 35 percent in 2014 and 2013, 33 percent in 2012, and 32 percent in 2011.
Finally, we were alarmed by the data showing the connection between heroin and benzodiazepines misuse. Our data showed one in three heroin users combine their drug use with benzodiazepines, the vast majority of which were unprescribed. This is an extremely dangerous practice given that benzodiazepines can have strong respiratory depressant effects when combined with other substances. Drug combinations, but particularly of heroin with benzodiazepines, can be potentially very dangerous, leading to coma and even death in some cases.
MedicalResearch.com: What should readers take away from your report?
Response: The takeaway for physicians is that prescription drug misuse is prevalent and potentially dangerous for patients. Even though misuse rates are declining, our study found that one in two Americans misuse their drugs. Our study did not examine why the misuse rate is so high, but we have some theories. Patients may not understand prescribing instructions and fail to take medication as prescribed, or stop taking their prescriptions for other reasons. Others may be unaware of the dangers of combining drugs. And in some cases, patients may intentionally abuse prescription substances. In these cases, a little education may go a long way toward preventing a tragedy.
Sometimes physicians tell me that they can tell which patients are abusing their drugs. But our Quest data doesn’t support this premise. The data shows that across all ages, regions and socioeconomic levels, prescription drug misuse is a problem for a significant number of patients. Don’t assume that you know if your patient is taking their medication properly based on how they look, their type of job or their education level. Laboratory testing provides objective data that can help assess risk of drug misuse, and that’s why the CDC now recommends it for certain situations. Consider all of the options available to you as a physician to monitor for appropriate and inappropriate drug use.
We also hope these findings are useful in highlighting the risks for patients taking prescription medications so that they exercise better compliance. Finally, public health officials and policymakers may also find the analysis useful when considering programs and policies to address the prescription drug epidemic.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The Quest Diagnostics laboratory database is based on 20 billion tests, making it the largest private database of clinical lab data. From this database, we examined different types of misuse as they applied to gender, geography, age and health plan. Analysis to understand the reasons for why a majority of patients showed signs of misuse was beyond the scope of our analysis and would be a worthy focus for additional research.
MedicalResearch.com: Is there anything else you would like to add?
Response: Prescription pain-relieving drugs, such as opioids, help alleviate pain for millions of people. But these drugs also hold many potential dangers. Laboratory testing — including population analysis of lab data — can provide important insights into the risk of inappropriate prescription drug use by individuals and populations. Physicians who commit to educating and monitoring patients for the appropriate use of prescription drugs can help reduce the number of people at risk. That would be an important step toward creating healthier patients and a healthier world.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
F. Leland McClure III, MSci, PhD, F-ABFT, is medical science liaison director for Quest Diagnostics. Quest is the leader in diagnostic information services, including physician-ordered prescription medication monitoring services. The company provides a comprehensive drug testing menu and detailed medMATCH® reports with interpretations based on prescription information.
For more information, visit www.QuestDiagnostics.com/PDM
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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