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For ER Patients, Self-Reported Drug Ingestion History Poor

Poor concordance when histories are confirmed by urine comprehensive drug screen

TUESDAY, Jan. 6, 2015 (HealthDay News) -- For patients presenting to the emergency department, self-reported drug ingestion histories are poor when confirmed by urine comprehensive drug screen (CDS), according to a study published in the January issue of The Journal of Clinical Pharmacology.

Andrew A. Monte, M.D., from the University of Colorado Department of Emergency Medicine in Aurora, and colleagues examined the accuracy of self-reported drug ingestion histories in 55 patients presenting to an urban academic emergency department. A structured drug ingestion history was obtained for the 48 hours prior to emergency department presentation for all prescription drugs, over-the-counter (OTC) medications, and illicit drugs. CDSs were obtained and self-report/CDS concordance was examined.

The researchers found that self-reported drug ingestion histories were poor; 30.9 percent of histories were concordant with CDS. For the individual drug classes, concordance varied and was 58.2 percent for prescription drug-CDS, 60 percent for OTC-CDS, and 81.8 percent for illicit drug-CDS. There was no correlation noted between demographic factors and self-reported drug history. Drugs were detected by CDS but unreported in 16 patients; nine included an unreported opioid.

"In conclusion, self-reported drug ingestion histories are often inaccurate and resources are needed to confirm compliance and ensure unreported drugs are not overlooked," the authors write.

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