Development of an addiction recovery patient-reported outcome measure: Response to Addiction Recovery (R2AR)

Substance Abuse Treatment, Prevention, and Policy

Research

Constance M. Horgan¹  Elisabeth Okrant¹  Sharon Reif¹ 

[1] Institute for Behavioral Health, Schneider Institutes for Health Policy and Research, Heller School for Social Policy and Management, Brandeis University, MS035, 415 South Street, 02453, Waltham, MA, USA;

关键词: Substance use disorder;    Recovery;    Patient-reported outcomes;    Measure development;    Clinical assessment;    Quality measurement;   

DOI  :  10.1186/s13011-023-00560-z

 received in 2023-05-21, accepted in 2023-08-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRecovery, a primary goal of addiction treatment, goes beyond abstinence. Incorporating broad domains with key elements that vary across individuals, recovery is a difficult concept to measure. Most addiction-related quality measurement has emphasized process measures, which limits evaluation of treatment quality and long-term outcomes, whereas patient-reported outcomes are richer and nuanced. To address these gaps, this study developed and tested a patient-reported outcome measure for addiction recovery, named Response to Addiction Recovery (R2AR).MethodsA multi-stage mixed methods approach followed the Patient-Reported Outcomes Measurement Information System (PROMIS) measure development standard. People with lived experience (PWLE) of addiction, treatment providers, and other experts contributed to item distillation and iterative measure refinement. From an item bank of 356 unique items, 57 items were tested via survey and interviews, followed by focus groups and cognitive interviews.ResultsFace validity was demonstrated throughout. PWLE rated item importance higher and with greater variance than providers, yet both agreed that “There are more important things to me in my life than using substances” was the most important item. The final R2AR instrument has 19 items across 8 recovery domains, spanning early, active, and long-term recovery phases. Respondents assess agreement for each item as (1) a strength, and (2) importance to ongoing recovery.ConclusionR2AR allows PWLE to define what is important to their recovery. It is designed to support treatment planning as part of clinical workflows and to track recovery progress. Inclusion of PWLE and providers in the development process enhances its face validity. Including PWLE in the development of R2AR and using the tool to guide recovery planning emphasizes the importance of patient-centeredness in designing clinical tools and involving patients in their own care.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 1