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Should I consider prescription drug management testing if I don't participate in pain management?

Often doctors think Prescription Drug Management, or PDM, testing is to see if any illegal drugs are being used.  While this is certainly a use of PDM testing, it is not the real reason.  Many medications that are not considered pain medications are used to treat depression, anxiety, convulsions, and common cold symptoms, and can still be harmful if not taken properly.  It is important that patients taking any of these medications in a chronic state be routinely monitored to see if the drugs are being taken properly and that the patient is benefitting from the medication.  It is important to monitor the drugs being used to ensure they are present and that no new agents could cause an adverse drug event. 

Why should I order confirmation testing?

Immunoassays targeted at a drug class typically do not detect each drug within the class equally. Many tests do not reliably detect the most commonly prescribed medications in this class. In fact, the false negative rate for some classes of drugs can be has high as 50%. Drinking large quantities of water can also alter the testing and show a false negative. Many widely-used and prescription drugs may also trigger false positive results. Even the package inserts of most in-house testing states that it should only be used as preliminary testing. Because of the high probability of false negatives and false positives, it is imperative that all preliminary tests be sent off for confirmation.

Shouldn't I just trust my patients?

Even when patients are 100% truthful about their use of medications, there may be times when patients unknowingly take other medications.  For example, if one of your patients receives pain medication for a surgery and only takes part of the prescription, he may keep the rest of the medication in case the pain later reemerges. At his next visit, this patient discloses that he is not on any current medications, and you write him a prescription for an anti-depressant. Imagine if this patient's pain later returns, and he decides to take the rest of the pain medication? Now the patient is taking two medications that could potentially be life-threatening.  This is when most adverse drug reactions happen, and they happen frequently. In fact, a recent study showed 34% of the patients were taking life-threating combinations of different medications.

It’s not about catching your patients, but protecting them.

Isn't this testing expensive?

Our PDM testing is reimbursed by most payers: commercial and Medicare. We are covered by many major insurance providers, and we accept all insurances. We also have affordable patient pricing for those without insurance.