AUGUST 4, 2025
New research suggests patients who complete a patient prescriber agreement (PPA) following opioid treatment for cancer pain had lower rates of aberrant urine drug tests.
Currently, it is recommended that PPAs can be used to improve patient adherence and reduce nonmedical opioid use during opioid therapies. However, researchers previously had not examined its efficacy for patients with cancer.
In the study, a team of investigators examined the impact of PPA completion on aberrant urine
New research suggests patients who complete a patient prescriber agreement (PPA) following opioid treatment for cancer pain had lower rates of aberrant urine drug tests.
Currently, it is recommended that PPAs can be used to improve patient adherence and reduce nonmedical opioid use during opioid therapies. However, researchers previously had not examined its efficacy for patients with cancer.
In the study, a team of investigators examined the impact of PPA completion on aberrant urine drug tests, which is seen as a nonmedical opioid use indicator, within three and six months following PPA completion.
The team retrospectively reviewed demographic and clinical information for patients who received opioids for cancer pain and completed a PPA. The patients in this group were compared with a similar group of patients who did not complete a PPA.
The researchers employed both univariable and multivariable regression models to determine the factors linked to aberrant urine drug tests.
The results showed 53% (n=126) and 64% (n=150) of eligible patients had urine drug test results within three and six months, respectively. Within these groups, 73% (n=92) and 71% (n=107) of patients signed a PPA, respectively.
Patients who completed a PPA were linked to significantly lower aberrant urine drug test rates within three months (odds ratio [OR], 0.28; 95% CI, 0.09-0.76; P=0.02).
The investigators also found higher baseline pain expression (OR, 1.22; 95% CI, 1.04-1.46; P=0.02), higher morphine equivalent daily dose (OR, 1.07; 95% CI, 1.02-1.14; P=0.02) and history of illicit drug use (OR, 8.39; 95% CI, 3.31-23.57; P<0.001) were associated with aberrant urine drug tests within three months of completing a PPA. These associations remained significant at six months.
“Patients who signed a PPA had significantly lower rates of aberrant [urine drug tests] within the following three months compared to patients who did not. The findings suggest that PPA may decrease [nonmedical opioid use] behaviors, highlighting its potential as a risk mitigation strategy,” the authors wrote.
— Kenny Walter
