• Julie Dupouy, Vincent Mémier, Hélène Catala, Michel Lavit, Stéphane Oustric, and Maryse Lapeyre-Mestre.
• Département Universitaire de Médecine Générale, Université de Toulouse; Faculté de Médecine, 133 route de Narbonne, 31063 Toulouse, France; Inserm UMR1027, Université de Toulouse III; Faculté de Médecine, 37 allées Jules Guesde, 31000 Toulouse, France. Electronic address: julie.dupouy@univ-tlse3.fr.
• Drug Alcohol Depend. 2014 Mar 1;136:11-20.

BackgroundIn the field of addiction, assessment of psychoactive substance use is a key element. Nevertheless, self-reports and clinical examination underestimate the use of psychoactive substances. The implementation of urine drug screening tests (UDS) should improve this assessment. While the diagnostic value of UDS is well demonstrated, the consequences of carrying out UDS on medical management have not been established. Our aim was to summarize the evidence pertaining to the efficacy of UDS for medical management.MethodsA systematic review of clinical trials, quasi-randomized and observational studies was performed using PubMed, Cochrane database of systematic review, Cochrane central register of controlled trials, PsycINFO, National Institute on Drug Abuse, ISI Web of Science. The methodological quality was assessed with the score developed by Starrels et al.; the report quality using the CONSORT and the STROBE checklists. The main outcome was medical management or consequences of management for patients in terms of psychoactive substance consumption and its complications, be they medical, social or professional.ResultsEight studies met the inclusion criteria: one randomized clinical trial, two quasi-randomized studies, one cohort, and four cross-sectional studies. The methodological quality was judged to be poor, with the exception of the randomized clinical trial (fair quality). The value of UDS in managing patients was not clearly indicated in these studies.ConclusionsFew studies, with poor quality, have assessed the value of UDS in managing patients using psychoactive substances; though with insufficiency to demonstrate the interest of carrying out UDS. Therefore, pragmatic intervention studies are necessary.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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