Kaiser Permanete's guidelines in the management of chronic BZD patients

[[Te...]]

FYI The guideline also states that the results of the UDS will be included in the patient’s permanent medical record and hints that the costs for this test may not be covered by the Kaiser Health Foundation Plan of Washington.

 

I hope that's conveyed to the patient. I'm wondering how much out-of-pocket expense it would be since most seniors are on a fixed income.

[[Li...]]

I hope that's conveyed to the patient. I'm wondering how much out-of-pocket expense it would be since most seniors are on a fixed income.

Good points, Terry38!

 

See pages 7 - 8 of the guideline for specifics re: what docs are supposed to discuss with the patient before the UDS.  One of the bullet points is the “Possibility of cost to the patient.” 

 

I am by no means an expert on UDS but here’s what I’ve learned after a very quick review of the literature.  (1) The most common UDS test is an immunoassay.  These tests have”poor specificity” and can produce false-negatives as well as false-positives. For example, clonazepam and lorazepam frequently produce false-negative results. (2) Other UDS tests such as gas chromatography–mass spectrometry or high-performance liquid chromatography are more accurate, but they are also more expensive. (3) Patients would be wise to (a) find out what the cost of the test(s) will be prior to testing *and* (b) verify that the lab conducting the test(s) is in-network or accepts Medicare assignment.

[[Te...]]

Why put the onus on the patient? After all, doctors are the ones who want this test done, and doctors are the ones who originally prescribed the benzos. Not every senior is going to be an addict...

 

 

[[Li...]]

Why put the onus on the patient? After all, doctors are the ones who want this test done, and doctors are the ones who originally prescribed the benzos. Not every senior is going to be an addict...

This is one of the many reasons I hope that the Benzo Info Coalition will seize this opportunity to educate a health plan provider that serves 700K patients about how this guideline could be improved.

[[Te...]]

Yes! I do hope that the Benzo Coalition gets involved, although they have members who are still not healed, so that is rough.