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As the limitations of urine testing for compliance monitoring are better understood by healthcare practitioners (HCPs), many are turning to blood analysis to learn if their patients are taking more or less medication than prescribed.
However, the sophisticated nature of blood testing raises a new set of questions for HCPs who may be unfamiliar with the process. To present toxicology results in a way that is easy for practitioners to understand, AIT is proud to add blood dose correlations to its compliance testing menu.
Blood dose correlations consist of pharmacokinetic equations widely accepted in the scientific community. AIT’s toxicologists use these equations to predict the steady-state range for a patient on a specific dosing regimen and then compare it against the patient’s quantitative blood level. On AIT’s toxicology report, it plainly states if the drug concentration found in the patient’s system falls within the expected steady-state range, simplifying results interpretation and helping HCPs make more informed decisions faster.
“We are literally correlating the concentration found in the blood to the dose prescribed by the HCP,” explained Toxicology Consultant Gina Cooper. “Knowing if a patient falls within steady state can help the HCP open a dialogue with the patient. If the patient is below steady state, the HCP may want to find out if the patient understands how to take their medication, if there are unpleasant side effects the patient is trying to avoid, if they are keeping their medication locked in a safe place, etc."
She added, “Similarly, if the patient’s blood level is above steady state, the HCP may want to discuss whether or not the prescribed regimen is giving adequate pain control and where the additional medication is coming from.”
“Many patients have come to realize that as long as they are taking some of their prescribed medication, their urine will test positive for the appropriate drug and/or metabolite,” said Toxicologist and Manager of Scientific Education Josh Gunn, Ph.D. “While the presence of a prescribed drug in the urine indicates recent ingestion, many providers are turning to blood dose correlations to ensure that medications are being taken in the prescribed manner.” Read Josh Gunn’s Q&A with Pain Live on the differences between urine and blood compliance testing.
HCPs who struggle with results interpretation are one of several practitioner groups that stand to gain the most benefit from blood dose correlations. “Every provider wants to ensure that the medication they are prescribing is not being diverted or being taken in an inappropriate manner. Blood dose correlations are allowing providers to confirm that these higher-dose patients do indeed require the prescribed dose, thus mitigating the risk of diversion,” Gunn said.
Not everyone is a candidate for blood dose correlations. For instance, patients need to follow a scheduled, multi-dose daily regimen that allows them to reach a steady state so that an expected range can be calculated. “Blood dose correlations should only be performed for medications being taken on a consistent or ‘round the clock’ basis. Medications being taken on a PRN or ‘as needed’ basis will rarely achieve steady state due to inconsistent dosing – such medications are not good candidates for blood dose correlations,” Gunn said. Other considerations include the rate of metabolism, time of last dose and route of administration.
But when patients do meet the requirements, the information offered through blood dose correlations is invaluable. “Routine blood dose correlations allow HCPs to identify patients who may be under- or overmedicating. This piece of information cannot be obtained through routine urine drug testing,” Gunn said.
To learn more about AIT’s blood testing services, click here.
AIT Laboratories, headquartered in Indianapolis, Ind., is a national healthcare company that specializes in compliance testing, forensic toxicology drug testing and clinical laboratory testing. AIT is recognized nationwide for superior customer service and quality in testing. Follow us on Twitter and like us on Facebook.