New saliva test monitors patients’ adherence to chronic opioids

A Colorado-based company announced that it has developed the first patient-monitoring screening test that utilizes a salvia sample, rather than urine sample, to provide clinicians with more detailed information regarding a patient’s prescription pain medication misuse and nonadherence.

The Cordant Comprehensive Oral fluid Rx Evaluation system, or CORE, is a screening tool that uses a saliva sample to associate oral fluid prescription pain medication levels to an expected level at steady-stage range, according to a manufacturer press release. This supplementary information could aid physicians in determining which patients are adhering to prescription regimens, and, in turn, could limit drug diversion while enhancing patient safety and therapy adherence.

“This is not something that replaces the clinical judgment of the physician, it is a tool for them to better manage the patient,” Richard Stripp, PhD, chief scientific and technology officer at Cordant Health Solutions, said in a conference call.

The expected steady-state range is based upon factors such as dose, frequency of the dose, the patient’s body weight and the drug itself, he added, noting that CORE typically generates more accurate results than a urine test.

“These tests are confirmed by liquid chromatography and mass spectrometry, which gives us a fingerprint for that particular drug or metabolite, so the likelihood that you would find a false positive or a false negative is extremely low,” Stripp said in the call.

CORE provides readings of within range, above range, below range or negative, and has several advantages over urine and blood tests, company representatives said.

“Urine testing can’t determine if a patient is adhering to exact dosing because the only information given to the physician is whether the patient had taken the drug before urine collection and not if proper dosing is being followed,” Kwesi Grant-Acquah, MD, an internal medicine physician at Omni Family Medical in Milwaukee, said in the release.

“[In addition], collection of urine specimens usually is not observed, so the possibility of sample adulteration always exists. Urine tests can be beaten easily and too many people skate through.”

“While blood testing can report dose correlation results, it is invasive, expensive and requires trained staff. With CORE, providers get similar benefits to blood testing with the convenience of noninvasive sample collection and without concern for sample adulteration,” Stripp said in the release.

CORE can be applied to any chronically administered medications but is only validated for pain medications, he added, noting that the company aims to expand those validations to other drugs in the future. — by Janel Miller

Disclosure: Stripp reports holding less than 2% interest in Cordant Health Solutions. Healio Family Medicine was unable to determine Acquah’s relevant financial disclosures before publication.