An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders

Author:

Black Nicola1,Chung Sophie2,Tisdale Calvert1ORCID,Fialho Luz Sousa2,Aramrattana Apinun3ORCID,Assanangkornchai Sawitri4ORCID,Blaszczynski Alex5,Bowden-Jones Henrietta67,van den Brink Wim8ORCID,Brown Adrian9,Brown Qiana L.10,Cottler Linda B.11,Elsasser Maury12,Ferri Marica13ORCID,Florence Maria14,Gueorguieva Ralitza15,Hampton Ryan16,Hudson Suzie17,Kelly Peter J.18,Lintzeris Nicholas19,Murphy Lynette20,Nadkarni Abhijit2122ORCID,Neale Joanne23ORCID,Rosen Daniel24,Rumpf Hans-Jürgen25,Rush Brian26ORCID,Segal Gabriel27,Shorter Gillian W.2829ORCID,Torrens Marta30ORCID,Wait Christopher31,Young Katherine2,Farrell Michael1

Affiliation:

1. National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia

2. International Consortium for Health Outcomes Measurement, London W12 8EU, UK

3. Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

4. Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand

5. School of Psychology, Brain and Mind Centre, Faculty of Science, University of Sydney, Sydney 2006, Australia

6. Department of Psychiatry, University College London, London NW1 2AE, UK

7. Department of Psychiatry, Cambridge University, Cambridge CB2 1QW, UK

8. Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands

9. Northwick Park Hospital, Central and North West London Trust, London HA1 3UJ, UK

10. School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA

11. Department of Epidemiology, College of Medicine & Public Health and Health Professions, University of Florida, Homestead, FL 33031, USA

12. Independent Researcher, South Berwick, ME 03908, USA

13. Department of Psychology, Faculty of Community and Health, European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal

14. Department of Biostatistics, School of Public Health, University of the Western Cape, Cape Town 7535, South Africa

15. Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06511, USA

16. The Voices Project, Las Vegas, NV 89149, USA

17. Network of Alcohol and Other Drugs Agencies, Sydney 2751, Australia

18. Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, Australia

19. Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia

20. Independent Researcher, Sydney 2000, Australia

21. Addictions and Related Research Group, Sangath, Bardez 403501, Goa, India

22. Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK

23. Addictions Department, King’s College London, London SE1 9NH, UK

24. School of Social Work, University of Pittsburgh, Pittsburgh, PA 15213, USA

25. Translational Psychiatry Unit, Universität zu Lübeck, 23562 Lübeck, Germany

26. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada

27. Department of Philosophy, King’s College London, London SE1 9NH, UK

28. Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast BT9 5AJ, UK

29. Institute of Mental Health Sciences, Ulster University, Coleraine BT52 1SA, UK

30. Addiction Service, Hospital del Mar, 08003 Barcelona, Spain

31. Build on Belief, London SW5 9HB, UK

Abstract

Background: In 1990, the United States’ Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018–March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer–patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.

Funder

NHS England and NHS Improvement

the NSW Agency for Clinical Innovation, Australia

Providence Health Care, USA

egion Västra Götaland, Sweden

Publisher

MDPI AG

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