妊娠期异常尿液药物筛查-实验室管理的机会。

Q2 Medicine
Anil K Chokkalla, Sahil Malik, Ridwan Ibrahim, Sridevi Devaraj
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引用次数: 0

摘要

背景:药物滥用的临床测试通常包括最初的筛选,然后是确认性测试。由于有限的循证指南,医疗保健提供者根据临床情况决定是否确认异常筛查。事实证明,这种两步法在母亲药物滥用和随后的胎儿/新生儿暴露等情况下是不够的。本研究的目的是评估和提高在我们妇女中心的孕妇中异常筛查的确诊率。方法:采用回顾性图表法评估阳性筛查孕妇的确证率,并实施实验室管理倡议,提醒订货医师确证性药物试验的重要性。根据与药物相关的干扰、社会历史和提供者笔记中自我报告的物质使用情况,将异常筛查归类为预期阳性。结果:在干预前,药物筛查意外阳性的孕妇中只有28%接受了确认性检测,而在干预后,这一比例显著上升至67%。此外,结果分析显示,50%的患者在干预后被转介到社会工作和精神病学。结论:本研究强调了实验室管理在优化孕妇药物检测实践中的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abnormal Urine Drug Screens in Pregnancy- Opportunity for Laboratory Stewardship.

Background: Clinical testing for drugs of abuse typically involves initial screening followed by confirmatory testing. Due to limited evidence-based guidelines, the healthcare provider makes the decision to confirm abnormal screens based on the clinical context. This two-step approach proved to be inadequate in scenarios like maternal substance abuse and subsequent fetal/ newborn exposure. The goal of this study is to assess and improve the confirmatory testing rate of abnormal screens among pregnant patients at our women's center.

Methods: A retrospective chart review was conducted to assess the confirmation rates among positively screened pregnant patients, and a lab stewardship initiative was implemented to remind ordering physicians about the importance of confirmatory drug tests. Abnormal screens were classified as expected positives based on the medication-related interference, social history and self-reported substance use from the provider notes.

Results: Only 28% of pregnant patients with unexpected positive drug screens underwent confirmatory testing during the pre- intervention period, which rose significantly to 67% during the post-intervention period. Furthermore, outcome analysis revealed that 50% of patients with concordant confirmatory test results were referred to social work and psychiatry in the post-intervention period.

Conclusions: This study highlights the value of laboratory stewardship in optimizing drug testing practices for pregnant patients.

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CiteScore
2.30
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