applied aatod presentation highlights

applied strategic

outcomes measurement tool in opioid

dependence care

2015 AATOD National Conference – Atlanta

Dr. Richard Littlewood

March 29, 2015

Survey results: need for improved outcome

measures

2

Strongly

agreeNeutral 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%S

tron

gly

agre

e

Agre

e

Ne

utr

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Dis

agre

e

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on

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dis

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ree

1

Results from expert survey

Statement:

applied strategic

Survey results: potential limitations of current

measures

3

Strongly


disagree

Agree

Currently used outcome

measures (completions,

readmissions) may be too

simple to capture full benefit of

treatment

20%

14%

6%

0%S

tron

gly

agre

e

Agre

e

Ne

utr

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Dis

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on

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dis

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2

60%

Statement:

applied strategic

Results from expert survey

• 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 RiskIn

div

idu

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So

cie

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Concept: more than one value needed to describe

outcomes (because there are many factors)

applied strategic 4

• Avoiding crime,

including OST

diversion

• Participation in a

treatment programme

• Improving health status,

avoiding misuse/

injecting drug use

• Work status

Recovery RiskIn

div

idual

Socie

ty

The critical elements for measurement of outcomes: how

can it work in practice?

applied strategic 5

Progression RiskIn

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So

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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


disagree

Agree

32%

51%

15%

2% 0%

Str

on

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agre

e

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Dis

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Source: Alho Maremmani Littlewood 2014

applied strategic 7

Avoiding on-top use of opioids is

the right way to measure

outcomes in ODM

Outcome metric:

Strongly


disagree

Agree

Results from consensus process:

On-top use

40%

53%

4% 2% 0%

Str

on

gly

agre

e

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Ne

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Dis

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style process: HEALTH/ RISK

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


disagree

Agree

40%

53%

7%0% 0%

Str

on

gly

agre

e

Agre

e

Ne

utr

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Dis

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style process: WORK


style process: CRIME

applied strategic 9

Reduction in criminal activity is the

right way to measure treatment

outcomes in ODM

Outcome metric:

Strongly


disagree

Agree

Results from consensus process:

Criminal activity

66%

32%

2% 0% 0%

Str

on

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agre

e

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Dis

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• 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 RiskIn

div

idual

Socie

ty

An outcomes tool for real life..

applied strategic 10

Progression RiskIn

div

idu

al

So

cie

ty

applied aatod presentation highlights

Healthcare