Durback L F, Scharman E J, Brown B S
West Virginia Poison Center, West Virginia University School of Pharmacy, Charleston, USA.
Vet Hum Toxicol. 1998 Aug;40(4):234-7.
Previous studies evaluated the prudent use and potential over use of drug screens in clinical decision making. However, the percentage of emergency physicians who can correctly identify which drugs are found on their hospital's basic drug screens has not been established. Results of physician closed-ended questionnaires were compared to the results of a telephone survey with each physician's individual hospital laboratory. Eighty-one (35.7%) of 227 emergency physicians responded. Four (4.9%) correctly identified what was on their individual institution's urine drug screens and 17 (21%) correctly identified what was on serum screens. In other results, 74.3% erroneously relayed that all benzodiazepines can be found on urine drug screens and 46.3% incorrectly answered that acetaminophen would be found on basic quantitative serum screens. Drug screen results can be misinterpreted if the drugs the physician expects to be screened for, and what is actually screened for, are not the same. Pharmacy and laboratory personnel have a responsibility to keep the physician informed of drug screen issues. They should be proactive in advising physicians of changes in drug testing and new drug screening methods or by providing reports on the occurrence of false positive results.
以往的研究评估了在临床决策中药物筛查的合理使用及潜在的过度使用情况。然而,能正确识别其所在医院基本药物筛查中所检测药物的急诊医生的比例尚未确定。将医生封闭式问卷的结果与对每位医生所在医院实验室进行电话调查的结果进行了比较。227名急诊医生中有81名(35.7%)做出了回应。其中4名(4.9%)正确识别了其所在机构尿液药物筛查的项目,17名(21%)正确识别了血清筛查的项目。在其他结果中,74.3%错误地表示所有苯二氮䓬类药物都能在尿液药物筛查中被检测到,46.3%错误地回答对乙酰氨基酚会在基本定量血清筛查中被检测到。如果医生期望筛查的药物与实际筛查的药物不一致,药物筛查结果可能会被误解。药剂师和实验室人员有责任让医生了解药物筛查问题。他们应积极主动地向医生通报药物检测的变化、新的药物筛查方法,或提供关于假阳性结果发生情况的报告。