Rollston Rebekah, Burke Barbara, Weiner Scott G, Gallogly Winifred, Brandon Apryl D, Carter Robyn, Clear Brian
Bicycle Health, Inc., Boston, MA, United States of America.
Bicycle Health, Inc., Boston, MA, United States of America; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.
J Subst Use Addict Treat. 2023 Nov;154:209151. doi: 10.1016/j.josat.2023.209151. Epub 2023 Aug 29.
As telehealth models for treatment of opioid use disorder (OUD) are expanding, the field does not know the reliability of urine drug screening (UDS) in this setting. The objective of this study is to determine the rate of falsification of UDS testing among patients with OUD in active treatment with buprenorphine via a telehealth provider.
This is a prospective cohort study of 899 randomly selected eligible patients, of which 392 participated in the final cohort that the study team used for analysis. The study mailed patients a UDS cup and asked them to return the sample by mail. After the UDS sample was received, a buccal swab was mailed, and the study asked patients to schedule a virtual meeting in which consent was sought and an observed buccal swab was obtained. We evaluated urine for evidence of falsification, and used buccal swabs to genetically match individuals to urine samples.
After exclusion criteria, 395 (52.3 %) of 755 patients who received a UDS kit returned it for analysis prior to knowledge of the study. Of that, 392 samples had sufficient quantity for testing. We determined 383 (97.7 %) to be human urine containing buprenorphine without indication of exogenous buprenorphine addition and with evidence of compliance. A total of 374 patients received a buccal swab kit and 139 (37.2 %) attended the consent/observed buccal swab session. One hundred and thirty-two patients consented and completed the swab under video observation, and 120 successfully sent the swab back to the external laboratory. Of the 120 buccal swabs received, 109 (90.8 %) were a genetic match, 10 (8.3 %) were indeterminate, and 1 (0.8 %) was a genetic mismatch.
This study of patients treated by a telehealth OUD provider demonstrated a low rate of urine test falsification.
随着用于治疗阿片类物质使用障碍（OUD）的远程医疗模式不断扩展，该领域尚不清楚在此背景下尿液药物筛查（UDS）的可靠性。本研究的目的是确定通过远程医疗提供者接受丁丙诺啡积极治疗的OUD患者中UDS检测结果造假的发生率。
这是一项对899名随机选择的符合条件患者进行的前瞻性队列研究，其中392名患者参与了研究团队用于分析的最终队列。研究给患者邮寄了一个UDS杯，并要求他们通过邮寄方式返还样本。在收到UDS样本后，邮寄了一个颊拭子，并要求患者安排一次虚拟会议，在会议上寻求同意并获取观察到的颊拭子样本。我们评估尿液样本是否有造假迹象，并使用颊拭子对个体与尿液样本进行基因匹配。
在排除标准后，755名收到UDS试剂盒的患者中有395名（52.3%）在了解研究之前就将其返还用于分析。其中，392个样本有足够的量用于检测。我们确定383个样本（97.7%）是含有丁丙诺啡的人尿，没有添加外源性丁丙诺啡的迹象且有依从性证据。共有374名患者收到了颊拭子试剂盒，139名（37.2%）患者参加了同意/观察颊拭子采集环节。132名患者同意并在视频观察下完成了拭子采集，120名患者成功将拭子送回外部实验室。在收到的120个颊拭子中，109个（90.8%）基因匹配，10个（8.3%）结果不确定，1个（0.8%）基因不匹配。
这项对由远程医疗OUD提供者治疗的患者进行的研究表明尿液检测造假率较低……
