Methods to reduce false reporting of substance abstinence in clinical research

Int J Methods Psychiatr Res. 2018 Sep;27(3):e1603. doi: 10.1002/mpr.1603. Epub 2018 Jan 4.

Abstract

Objectives: Substance use may influence study results in human subjects research. This study aims to report the concordance between self-report and biochemical assessments of substance use and test the effect of methods to reduce false reports of abstinence in trauma-exposed women participating in a research study.

Methods: In this pilot study, substance use was assessed during telephone prescreening and via self-report and biochemical verification (i.e., urine toxicology and alcohol breathalyzer tests) at an in-person evaluation. Due to the high number of participants who tested positive for substances despite self-reporting abstinence during prescreening, study procedures were modified to disincentivize false self-reports of substance use two thirds of the way through recruitment. New potential participants were explicitly informed during prescreening and informed consent that a positive drug or alcohol test during screening would result in exclusion from the study and withholding of payment.

Results: Prior to modifying study methods, 20% of participants who had reported abstinence during the telephone prescreen had a positive substance use test at the in-person visit. Modifying study procedures resulted in an 81% decrease in positive substance use assessments.

Conclusions: Adoption of this methodology may decrease inadvertent confounding of clinical research outcomes by undetected and/or misreported substance use.

Keywords: biochemical verification; drug testing; post-traumatic stress disorder; substance abuse; trauma.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Abstinence
  • Biomedical Research / standards*
  • Breath Tests
  • Female
  • Humans
  • Middle Aged
  • Pilot Projects
  • Self Report / standards*
  • Substance Abuse Detection / standards*
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / metabolism
  • Telephone
  • Urinalysis
  • Young Adult