Overview of the AACC 2018 Laboratory Medicine Practice Guideline – Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients


Clinical laboratories are now routinely engaged in the urine drug testing performed to assure adherence to therapy in chronic pain management patients, particularly when opioids are prescribed. This type of testing is unique from traditional workplace drug testing and emergency toxicology yet no practice guidelines have been available… until now! The AACC Academy has recently published the first laboratory medicine practice guidelines for monitoring adherence to therapy in chronic pain management patients. This presentation will describe the process for authoring the guidance document, as well as review the 26 evidence-based recommendations and 7 consensus-based expert opinions, emphasizing how laboratories can promote appropriate utilization and practices.

Originally published on July 17, 2018

Lecture Presenter

Gwendolyn A. McMillin, PhD

Gwendolyn A. McMillin, PhD

Medical Director, Toxicology
ARUP Laboratories
Medical Director, Pharmacogenetics
ARUP Laboratories
Professor (Clinical), Pathology
University of Utah School of Medicine

Dr. McMillin is a professor of pathology at the University of Utah School of Medicine. She received her PhD in pharmacology and toxicology from the University of Utah and is certified by the American Board of Clinical Chemistry in clinical chemistry and toxicological chemistry. She is a member of ARUP’s R&D Executive Committee, and is actively involved in professional associations such as the International Association of Therapeutic Drug Monitoring and Clinical Chemistry (IATDMCT), the American Association for Clinical Chemistry (AACC), and the College of American Pathologists (CAP). Her primary interests include detection of neonatal drug exposures, pain management, and clinical applications and implementation of pharmacogenomics.


After this presentation, participants will be able to:

  • Describe the PICO(TS) strategy used to guide the literature search used to support authorship of the LMPG.
  • Explain the scoring system used by the AACC Academy in evaluating strength of the recommendations, and quality of evidence.
  • Explain the three tiers of drug testing.
  • Compare qualitative screening with qualitative definitive testing.
  • List specimen validity tests the appropriate time for performing such tests.

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories