The Treatment Effectiveness Assessment (TEA): an efficient, patient-centered instrument for evaluating progress in recovery from addiction

Walter Ling, David Farabee, Dagmar Liepa, Li-Tzy Wu, Walter Ling, David Farabee, Dagmar Liepa, Li-Tzy Wu

Abstract

The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients' progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none). The resulting Treatment Effectiveness Assessment (TEA) elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients' sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.

Keywords: brief instrument; global treatment progress; patient-centered; substance use disorders.

References

    1. Clay RA.What you need to know about health reform Substance Abuse and Mental Health Services Administration News [serial on the Internet] Sep-Oct 2010185[about 5 p]Accessed November 2, 2012
    1. Mauer BJ, National Council for Community Behavioral Healthcare Substance Use Disorders and the Person-Centered Healthcare Home Washington; National Council for Community Behavioral Healthcare; 2010Available from: Accessed November 2, 2012
    1. Ghitza UE, Sparenborg S, Tai B. Improving drug abuse treatment delivery through adoption of harmonized electronic health record systems. Subst Abuse Rehabil. 2011;2011(2):125–131.
    1. Marsden J, Farrell M, Bradbury C, et al. Development of the Treatment Outcomes Profile. Addiction. 2008;103(9):1450–1460.
    1. McLellan AT, Cacciola JC, Alterman AI, Rikoon SH, Carise D. The Addiction Severity Index at 25: origins, contributions and transitions. Am J Addict. 2006;15(2):113–124.
    1. Cacciola JS, Alterman AI, McLellan AT, Lin YT, Lynch KG. Initial evidence for the reliability and validity of a “Lite” version of the Addiction Severity Index. Drug Alcohol Depend. 2007;87(2–3):297–302.
    1. Carroll KM, Rounsaville BJ. On beyond urine: clinically useful assessment instruments in the treatment of drug dependence. Behav Res Ther. 2002;40(11):1329–1344.
    1. Barry KL, Blow FC, Willenbring ML, McCormick R, Brockmann LM, Visnic S. Use of alcohol screening and brief interventions in primary care settings: implementation and barriers. Subst Abus. 2004;25(1):27–36.
    1. Pilowsky DJ, Wu LT. Screening for alcohol and drug use disorders among adults in primary care: a review. Subst Abuse Rehabil. 2012;3(1):25–34.
    1. McLellan AT, Luborsky L, Woody GE, O’Brien CP. An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index. J Nerv Ment Dis. 1980;168(1):26–33.
    1. O’Connell M, Tondora J, Croog G, Evans A, Davidson L. From rhetoric to routine: assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatr Rehabil J. 2005;28(4):378–386.
    1. Gagne C, White W, Anthony WA. Recovery: a common vision for the fields of mental health and addictions. Psychiatr Rehabil J. 2007;31(1):32–37.
    1. Piat M, Sabetti J, Couture A, et al. What does recovery mean for me? Perspectives of Canadian mental health consumers. Psychiatr Rehabil J. 2009;32(3):199–207.
    1. Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L. Examining the factor structure of the Recovery Assessment Scale. Schizophr Bull. 2004;30(4):1035–1041.
    1. Betty Ford Institute Consensus Panel What is recovery? A working definition from the Betty Ford Institute. J Subst Abuse Treat. 2007;33(3):221–228.
    1. [homepage on the Internet] SAMHSA’s working definition of recovery updated Substance Abuse and Mental Health Services Administration (SAMHSA)2012[updated March 23, 2012; cited Oct 2012]. Available from: Accessed November 2, 2012
    1. Boeri M, Whalen T, Tyndall B, Ballard E. Drug use trajectory patterns among older drug users. Subst Abuse Rehabil. 2011;2011(2):89–102.
    1. Nunnally JC. Psychometric Theory. 2nd ed. New York: McGraw-Hill; 1978.
    1. Gardner DG, Cummings LL, Dunham RB, Pierce JL. Single-item versus multiple-item measurement scales: An empirical comparison. Educ Psychol Meas. 1998;58(6):898–915.
    1. Drolet AL, Morrison DG. Do we really need multiple-item measures in service research? J Serv Res. 2001;3(3):196–204.
    1. Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med. 2010;170(13):1155–1160.
    1. Farabee D, Zhang S, Yang J. A preliminary examination of offender needs assessment: are all those questions really necessary? J Psychoactive Drugs. 2011;43(Suppl 7):51–57.
    1. Wu LT, Swartz MS, Pan JJ, et al. Evaluating brief screeners to discriminate between drug use disorders in a sample of treatment-seeking adults. Gen Hosp Psychiatry. 2012 Jul 20; Epub.
    1. Wu LT, Blazer DG, Woody GE, et al. Alcohol and drug dependence symptom items as brief screeners for substance use disorders: results from the Clinical Trials Network. J Psychiatr Res. 2012;46(3):360–369.
    1. Wu LT, Woody GE, Yang C, Pan JJ, Reeve BB, Blazer DG. A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults. Int J Methods Psychiatr Res. 2012;21(2):117–133.
    1. Dennis M, Scott CK, Funk R. An experimental evaluation of recovery management checkups (RMC) for people with chronic substance use disorders. Eval Program Plann. 2003;26(3):339–352.
    1. Pating DR, Miller MM, Goplerud E, Martin J, Ziedonis DM. New systems of care for substance use disorders: treatment, finance, and technology under health care reform. Psychiatr Clin North Am. 2012;35(2):327–356.

Source: PubMed

3
Se inscrever