Triage DOA^® versus INSTANT-VIEW M-1^® in Urinary Drug Screening for Acute Drug Poisoning: A Prospective Cross-sectional Study

Abstract

Objective In the management of patients with suspected acute drug poisoning, a screening test using the patient's urine is usually performed. The Triage DOA^® and INSTANT-VIEW M-1^® kits are two commonly used point-of-care screening kits in Japan. However, the relationship between the results of these screening kits and the blood concentration of the poisoning drug is not clear. In this study, we evaluated which kit is more useful for acute drug poisoning screening based on a comparison of their results with the results of a serum drug analysis.

Methods This prospective cross-sectional study investigated all patients with acute drug poisoning admitted to a general hospital in Tokyo, Japan, over a nine-month period. The Triage DOA^® and INSTANT-VIEW M-1^® screening kits were used, and a qualitative serum analysis was conducted simultaneously in all cases. We compared the kits for use in screening patients with acute drug poisoning and evaluated the utility of the kits.

Results For the 117 patients enrolled in this study, the 2 kits showed different sensitivities to benzodiazepines (Triage^®, 78.6%; INSTANT-VIEW^®, 90.5%). Both kits showed high sensitivity to barbiturates (Triage^®, 87.0%; INSTANT-VIEW^®, 91.3%) but low sensitivity to tricyclic antidepressants (Triage^®, 25.0%; INSTANT-VIEW^®, 45.8%).

Conclusion Because the sensitivity varies depending on the kind of drug, it is difficult to discuss the superiority of these kits. However, this study compared the results of two types of urinary drug screening kits with the results of qualitative analysis of drugs in serum as a gold standard, providing important reference data.