PtProtect® Patient Care

PtProtect® – Patient Care Toolkit

We’ve identified five steps to effectively manage your pain population:

1. Understand how to manage pain
Patients in pain can be a challenge. That’s why taking the time to understand how to manage pain through continuing medical education can be helpful, as you seek to serve them and improve the quality of their lives. Click here for resources.

2. Assess the patient’s pain
Determine if the patient suffers from chronic pain with assessments tool that facilitates discussion. Click here for resources.

3. Talk with the patient about your assessment
There are several tools available to guide you in this discussion. You may also download patient education materials. Click here for resources.

4. Keep a current chart

Special tools are available to maintain a chart for a patient undergoing chronic opioid therapy. Click here for resources.

5. Monitor for adherence

Promoting pain relief and preventing abuse of pain medications is a critical balancing act. PtProtect® is an important tool to help ensure prescription pain medications are available to patients who need them while preventing abuse, pain medication diversion and unintentional drug interactions.

Why monitor?

  • Patients who use illicit drugs are more likely to abuse prescription pain medications and divert medications either for financial gain or to fund an addiction to legal or illegal drugs.
  • Patients who use illicit drugs are at higher risk of combining such use with the legal drugs prescribed by health care providers, putting them at risk for overdose and adverse reactions. The Centers for Disease  Control and Prevention reports about one-half of prescription painkiller deaths involve at least one other drug, including benzodiazepines, cocaine and heroin. Alcohol is also involved in many overdose deaths.
  • Patients taking legally prescribed, controlled medications may be combining prescriptions from multiple prescribers, putting them at risk for overdose and adverse reactions. Patients who seek pain management care from multiple health care providers account for 40% of opioid overdoses in the U.S. (CDC). 
  • Patients taking legally prescribed, controlled medications may be combining them with alcohol or sedatives, putting them at risk for severe or fatal consequences. One study reports concurrent use of opioids and alcohol or sedatives in 12% and 32% of patients with chronic noncancer pain, respectively.1

PtProtect is designed to monitor chronic pain patient compliance to their prescription regimen. Drug classes detected in the PtProtect suite of tests include:

  • Opiates
  • Synthetic and natural opioids
  • Benzodiazepines
  • Alcohol
  • Illicit drugs

Why would a patient not have a drug present that was prescribed? 

One or more of the following circumstances could be responsible:

  • Non-compliance to the prescription regimen
  • Diversion of prescription drugs
  • Fast metabolizer of prescribed drugs
  • Drug induced metabolism (e.g. rifampin)
  • Poor drug absorption (e.g. celiac disease)
  • Diluted urine

Why would a patient have a drug present that was not prescribed? 

One or more of the following circumstances could be responsible:

  • Normal opiate/opioid metabolite from a legitimate prescription
  • Opiate/opioid metabolite found when high doses of codeine or morphine are used
  • High dose codeine can metabolize to hydrocodone
  • High dose morphine can metabolize to hydromorphone
  • Prescription from another health care provider
  • Medication obtained from a spouse, partner or friend
  • Illicit use of a drug obtained without a prescription


1 Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use: Jeffrey A. Gudin, MD, Shanthi Mogali, MD, Jermaine D. Jones, PhD, and Sandra D.Comer, PhD; Postgrad Med. 2013 July ; 125(4): 115–130. doi:10.3810/pgm.2013.07.2684.

PeaceHealth Laboratories