Value of "medication screening" in therapy for chronic pain

Introduction: Drug therapy plays often an important role in the treatment o f chronic pain. Former studies and also experiences of clinical practice ha ve given evidence, that insufficient patient compliance is a widespread eve nt. Therefore drug screening becomes a significant tool for quality assuran ce. In the following the methodical and practical aspects of drug screening are described and recommendations for its use in clinical practice are sug gested. Objective of drug screening: This tool can be used to check the intake of p rescribed drugs, to detect hidden taken drugs, to decide whether side effec ts result of the prescribed medication or not and to support a withdrawal t herapy. Practical basics and interpretation of the findings: Drug screening presupp oses an informed patient, who consents to the investigation. Otherwise conf idence is risked and the handling with unexpected results is not possible a ny more. Testing of urine has the advantage of a non invasive procedure and makes use of the reservoir of the bladder. A close co-operation and good c ommunication between therapist and laboratory prevents misinterpretations, which might result from inaccurate formulated questions or methodical limit ations, for instance because of cross reacting substances ora too insensiti ve detection level for the respective drug. The finding must primary bee us ed to value the therapy and improve the compliance but can not prove the pa tient himself. Conclusions: Even if the value of drug screening is not prospectively inves tigated until now, clinical experiences reveals it is as powerful tool for monitoring effectiveness and side effects of pharmacotherapy of pain and al so of patient compliance which the prescribed drug regimes.