AATOD presentation highlights

1. applied strategic
outcomes measurement tool in opioid
dependence care
2015 AATOD National Conference – Atlanta
Dr. Richard Littlewood
March 29, 2015

2. Survey results: need for improved outcome
measures
2
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
There is a lack of a universal
tools to measure all aspects of
care including aspects such as
recovery
29%
54%
17%
0% 0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
1
Results from expert survey
Statement:
applied strategic

3. Survey results: potential limitations of current
measures
3
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
Currently used outcome
measures (completions,
readmissions) may be too
simple to capture full benefit of
treatment
20%
14%
6%
0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
2
60%
Statement:
applied strategic
Results from expert survey

4. • Describe outcomes
related to treatment
choices, program
participation
• Identify outcomes
capturing a person’s
health state change/
risks e.g. injecting
• Determine the
impact of crime
associated with
dependence
• Describe impact of
dependence on
economic status,
others, family,..
Progression Risk
IndividualSociety
Concept: more than one value needed to describe
outcomes (because there are many factors)
applied strategic 4

5. • Avoiding crime,
including OST
diversion
• Participation in a
treatment programme
• Improving health status,
avoiding misuse/
injecting drug use
• Work status
Recovery Risk
IndividualSociety
The critical elements for measurement of outcomes: how
can it work in practice?
applied strategic 5
Progression Risk
IndividualSociety

6. Metrics were validated with experts in a Delphi
style process: TREATMENT
applied strategic 6
Engagement in treatment is the
right way to measure treatment
outcomes in ODM
Outcome metric:
Results from consensus process:
Engagement with treatment
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
32%
51%
15%
2% 0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
Source: Alho Maremmani Littlewood 2014

7. applied strategic 7
Avoiding on-top use of opioids is
the right way to measure
outcomes in ODM
Outcome metric:
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
Results from consensus process:
On-top use
40%
53%
4% 2% 0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
Source: Alho Maremmani Littlewood 2014
Metrics were validated with experts in a Delphi
style process: HEALTH/ RISK

8. applied strategic 8
Potential to work at appropriate
skill level is the right way to
measure outcomes in ODM
Outcome metric:
Results from consensus process:
Employment
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
40%
53%
7%
0% 0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
Source: Alho Maremmani Littlewood 2014
Metrics were validated with experts in a Delphi
style process: WORK

9. Metrics were validated with experts in a Delphi
style process: CRIME
applied strategic 9
Reduction in criminal activity is the
right way to measure treatment
outcomes in ODM
Outcome metric:
Strongly
agree
Neutral Disagree Strongly
disagree
Agree
Results from consensus process:
Criminal activity
66%
32%
2% 0% 0%
Stronglyagree
Agree
Neutral
Disagree
Stronglydisagree
Source: Alho Maremmani Littlewood 2014

10. • Am I avoiding
crime including
diversion of
treatment
• Am I engaged with a
treatment program?
• Is my health getting
better (and am I
avoiding risks like
injecting, use on top?)
• Am I working?
Recovery Risk
IndividualSociety
An outcomes tool for real life..
applied strategic 10
Progression Risk
IndividualSociety