We are considering changing the urine drug screen service we provide to
GPs, and would welcome any comments from the gp-uk community, in advance of
a targeted questionnaire we are likely to send.
Current Service -
a) Urine sample taken in surgery
b) Routine transport picks up all lab requests at limited set times of day
c) Requests received and processed into our computer system
d) Samples sent to another Bristol laboratory for analysis
e) Samples received and processed into their computer system
f) Batched analysis at set times of week
g) Reports produced by their computer system and dispatched to us
h) Results keyed into our computer system and authorised
i) Overnight printing of all GP reports by our computer system
j) Reports dispatched to GPs the next working day
k) GP sees result and does whatever
Current Analysis -
a) Basic drug screen detects amphetamines, benzodiazepines, cocaine,
methadone, and Opiates
b) TLC identifies opiate class and can detect barbiturates and
phenothiazines amongst other drugs
As you may imagine, this is not an ideal system, and is open to delays and
possible transcription errors. The overall turnaround as experience by GPs
(i.e. from date of sample to receipt of printed report is currently on
average 10 (real) days.
We have seen requests for urine drug screens rise exponentially in recent
years. The sheer volume of requests we receive have forced us to consider
providing a genuine in-house service for reasons of cost effectiveness and
quality of service.
We are interested (in general terms) what GPs want from such a service.
a) what drugs?
b) simple positive/negative?
c) cheap and cheerful or state of the art?
d) ideal turnaround?
d) when do decide to do a screen?
e) what difference does a result actually make to the patient - do they
care?
f) if you want to send us more of these (expensive) tests, what tests do
you want us to restrict or stop altogether ?
Although we are obviously a Bristol laboratory, we are not particularly
after Bristol specific comments, but after general thoughts. I find it
useful to bounce ideas around gp-uk before doing something 'properly'.
Thanks for any comments.
James Osborne
Pathology
United Bristol Healthcare NHS Trust
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