The Quest study verified what people involved in DOA testing already know: patients are not always compliant, and drug testing is needed to help detect diversion and abuse.
Diversion refers to the absence of a drug in a patient's sample because their prescribed drug was diverted to someone else (sold, lost, or given away). Diversion of a prescribed drug is just as serious as detecting an unprescribed drug. An earlier Quest study from 2012 showed that patients who were tested 30 days after an initial finding had 10% fewer unexpected findings. For pain medication, a 17% reduction was found when patients were retested. This shows that testing brought about less abuse by patients. The threat of getting caught caused at least some patients to become compliant before the next urine test.
Also of note is that the study showed that there was little difference in abuse/diversion rates between genders, across ages, and even across income levels. The problem is not limited to certain demographics but is widespread.