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The document describes the development of a strategic outcomes measurement tool for opioid dependence care. It discusses results from expert surveys that identified a need for improved and more comprehensive outcome measures. It then outlines key elements that should be measured, including treatment engagement, health status and risks, work status, and criminal activity. Metrics in these areas were validated with experts using a Delphi consensus process, which showed strong agreement that these metrics would appropriately measure outcomes in opioid dependence care.
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Applied 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