British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Oregon Health & Science University (OHSU)-Portland State University (PSU) School of Public Health, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; OHSU MD-PhD Program, School of Medicine, OHSU, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
Int J Drug Policy. 2019 Feb;64:30-33. doi: 10.1016/j.drugpo.2018.08.006. Epub 2018 Dec 12.
Opioid agonist therapy (OAT) is a first-line treatment for opioid use disorder (OUD); however, the efficacy and role of urine drug screening (UDS) in OAT has received little research attention. Prior evidence suggests that UDS frequency reflects philosophy and practice context rather than differences in patient characteristics or clinical need. Therefore, we reviewed the literature on the effect of and recommendations for the frequency of UDS on health outcomes for persons with OUD who receive OAT.
We searched Medline and EMBASE for articles published from 1995-2017. Search results underwent double, independent review with discrepancies resolved through discussion with a third reviewer, when necessary. Additional articles were identified through snowball searching, hand searching (Google Scholar), and expert consultation. The Cochrane tool was used to assess risk of bias.
Of the 60 potentially eligible articles reviewed, only one three-arm randomized open-label trial, comparing weekly and monthly UDS testing with take-home OAT doses, met our inclusion criteria.
Our review identified an urgent gap in research evidence underpinning an area of clinical importance and that is routinely reported by patients as an area of concern.
阿片类激动剂治疗（OAT）是治疗阿片类药物使用障碍（OUD）的一线治疗方法；然而，尿液药物筛查（UDS）在 OAT 中的疗效和作用却很少受到研究关注。先前的证据表明，UDS 的频率反映了哲学和实践背景，而不是患者特征或临床需求的差异。因此，我们回顾了有关接受 OAT 的 OUD 患者 UDS 频率对健康结果的影响和建议的文献。
我们从 1995 年至 2017 年在 Medline 和 EMBASE 上搜索了文章。搜索结果经过了双人、独立的审查，如有分歧，则通过与第三位审稿人讨论解决，必要时。通过滚雪球搜索、手工搜索（Google Scholar）和专家咨询确定了其他文章。使用 Cochrane 工具评估偏倚风险。
在审查的 60 篇潜在合格文章中，只有一项三臂随机开放标签试验符合我们的纳入标准，该试验比较了每周和每月 UDS 检测与带回家的 OAT 剂量。
我们的审查发现了一个在临床重要领域有迫切需要的研究证据空白，这也是患者经常关注的一个领域。
