Blog Post How 
services like Toxicology
The very idea of testing your patients to make sure they are remaininBlog Post How services like Toxicology
The very idea of testing your patients to make sure they are remaining compliant with their treatment is counter-intuitive, you are basically questioning your patients. Although, in this day, you can’t afford to not test your patients when their treatment calls for certain drug classes but let us look at other uses for toxicology testing…
Consider the use of toxicology testing to improve treatment. There are several scenarios where this ancillary service might function as such but I will focus today mainly on patients with anything other than a wild-type phenotype of the CYP system of enzymes responsible for most of the processing of the pharmaceuticals prescribed. In the context of toxicology, let’s look at a patient that does not respond well to the medication prescribed.
A patient that you have developed a provider-patient relationship with over several years visited you a month prior to today’s visit where they were prescribed pain medication to relieve the symptoms of sciatica. For the pain, you prescribed an opioid-class painkiller. They have returned today complaining of lethargy, constipation, and a general feeling of, in the patient’s own words, “being out of it, like I am constantly drunk.” With the history and patient’s chief complaint, you suspect the patient has abused the prescription you wrote them. You worry about the repercussions and begin to suspect that this patient isn’t as trustworthy as you once had thought.
After asking the patient and having them agree to a toxicology test, you obtain a sample and have it tested. The patient does, in fact, have a high level of opioid-based metabolites in their system. The patient brought in their prescription bottle and you count the number of pills. The number of pills actually make it look like the patient has barely taken any of the medication. You ask yourself whether the patient took more than was necessary before they came in to see you and you wonder about other possibilities. You then ask the patient to take a pharmacogenetics test.
The pharmacogenetics test indicates that the patient has a mutation in CYP2D6 indicating that the patient has a lower than normal processing phenotype for drugs metabolized by that enzyme. Taking into account the history of the patient and your relationship to them, the amount of prescription still not consumed, in conjunction with the toxicology test which helped lead to the pharmacogenetics test, you have a complete picture of this patient. You now understand that this patient must either consume a much smaller amount of the pharmaceutical or you must change drug classes to a drug that treats the symptoms while also being metabolized through a different enzyme (arguably, not too many options).
One test was not any more important than the other and this real world example reflects the process of which many prescribers take with their patients. In treating the patient and coming to the conclusion that treatment needed to be adjusted, you have improved patient outcome, patient satisfaction, and through testing you concluded what actually was occurring with this patient.
Patient satisfaction is the key to loyalty. In this age, no longer can you ignore the fact that patients have taken to rating your services either through forms of social media or through specific websites set-up to review physicians and healthcare providers. With rumors abound of tying reimbursement to patient satisfaction, you must consider every aspect of providing healthcare to your patients. From the time they set up an appointment to the time they walk into the waiting room, all the way until they are finished with their course of treatment, you have to keep satisfaction levels high.
Utilizing testing like toxicology and, in this example, pharmacogenetics, you see how important it can be to how a patient is treated and how you help bring them satisfaction concerning their care. This is just one example of how care is influenced through toxicology testing, there are many others. Should you have any questions or any comments, do not hesitate to get in touch with us at Ancillary Medical Solutions.
g compliant with their treatment is counter-intuitive, you are basically questioning your patients. Although, in this day, you can’t afford to not test your patients when their treatment calls for certain drug classes but let us look at other uses for toxicology testing…
Consider the use of toxicology testing to improve treatment. There are several scenarios where this ancillary service might function as such but I will focus today mainly on patients with anything other than a wild-type phenotype of the CYP system of enzymes responsible for most of the processing of the pharmaceuticals prescribed. In the context of toxicology, let’s look at a patient that does not respond well to the medication prescribed.
A patient that you have developed a provider-patient relationship with over several years visited you a month prior to today’s visit where they were prescribed pain medication to relieve the symptoms of sciatica. For the pain, you prescribed an opioid-class painkiller. They have returned today complaining of lethargy, constipation, and a general feeling of, in the patient’s own words, “being out of it, like I am constantly drunk.” With the history and patient’s chief complaint, you suspect the patient has abused the prescription you wrote them. You worry about the repercussions and begin to suspect that this patient isn’t as trustworthy as you once had thought.
After asking the patient and having them agree to a toxicology test, you obtain a sample and have it tested. The patient does, in fact, have a high level of opioid-based metabolites in their system. The patient brought in their prescription bottle and you count the number of pills. The number of pills actually make it look like the patient has barely taken any of the medication. You ask yourself whether the patient took more than was necessary before they came in to see you and you wonder about other possibilities. You then ask the patient to take a pharmacogenetics test.
The pharmacogenetics test indicates that the patient has a mutation in CYP2D6 indicating that the patient has a lower than normal processing phenotype for drugs metabolized by that enzyme. Taking into account the history of the patient and your relationship to them, the amount of prescription still not consumed, in conjunction with the toxicology test which helped lead to the pharmacogenetics test, you have a complete picture of this patient. You now understand that this patient must either consume a much smaller amount of the pharmaceutical or you must change drug classes to a drug that treats the symptoms while also being metabolized through a different enzyme (arguably, not too many options).
One test was not any more important than the other and this real world example reflects the process of which many prescribers take with their patients. In treating the patient and coming to the conclusion that treatment needed to be adjusted, you have improved patient outcome, patient satisfaction, and through testing you concluded what actually was occurring with this patient.
Patient satisfaction is the key to loyalty. In this age, no longer can you ignore the fact that patients have taken to rating your services either through forms of social media or through specific websites set-up to review physicians and healthcare providers. With rumors abound of tying reimbursement to patient satisfaction, you must consider every aspect of providing healthcare to your patients. From the time they set up an appointment to the time they walk into the waiting room, all the way until they are finished with their course of treatment, you have to keep satisfaction levels high.
Utilizing testing like toxicology and, in this example, pharmacogenetics, you see how important it can be to how a patient is treated and how you help bring them satisfaction concerning their care. This is just one example of how care is influenced through toxicology testing, there are many others. Should you have any questions or any comments, do not hesitate to get in touch with us at Ancillary Medical Solutions.