VA Connecticut Healthcare System, West Haven, CT, USA; Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, USA.
Yale University, School of Medicine, Department of Psychiatry, New Haven, CT, USA; Northeast Program Evaluation Center, VA Office of Mental Health and Suicide Prevention, West Haven VA Medical Center, West Haven, CT, USA.
J Subst Abuse Treat. 2022 Feb;133:108505. doi: 10.1016/j.jsat.2021.108505. Epub 2021 May 29.
Patient-centeredness is a cornerstone of substance use disorder (SUD) treatment. Patient-experience measures are potential tools for the routine assessment of patient-centered SUD care and may be valuable measures to inform quality monitoring improvement efforts. Little research exists on the predictive validity of patient-experience measures in SUD care.
We report on findings from the Veterans Outcome Assessment (VOA) survey that provides information on Veterans Health Administration SUD specialty care at treatment initiation and approximately 3-months post-initiation.
The VOA includes patient-reported outcomes across multiple domains, including the Brief Addiction Monitor (BAM-R), the Short-Form-12 (SF-12) and the Experience of Care and Health Outcome Survey (ECHO), and provides patient reports of the quality of provider communication and overall quality of SUD care.
Nearly 40% of veterans in SUD care gave the highest possible ratings for communication and quality at both baseline and follow-up. Ratings of communication at 3-months were associated with treatment discontinuation and both ratings of communication and quality at 3-months and were independently associated with SUD symptoms and with mental well-being at 3-months.
This study provides preliminary support for the inclusion of patient experience measures, particularly ratings of provider communication, as part of routine assessment in SUD care. However, further work on the validity of ratings of provider communication using additional methodologies is likely important before piloting the inclusion of such measures in routine assessment, such as in measurement base care.
以患者为中心是物质使用障碍（SUD）治疗的基石。患者体验衡量标准是常规评估以患者为中心的 SUD 护理的潜在工具，并且可能是告知质量监测改进工作的有价值的衡量标准。关于 SUD 护理中患者体验衡量标准的预测有效性的研究很少。
我们报告了退伍军人结果评估（VOA）调查的结果，该调查提供了有关退伍军人健康管理局 SUD 专科护理在治疗开始时和开始后大约 3 个月的信息。
VOA 包括多个领域的患者报告结果，包括简短成瘾监测器（BAM-R），简化健康调查量表 12 项（SF-12）和护理体验与健康结果调查（ECHO），并提供患者对提供者沟通质量和整体 SUD 护理质量的报告。
在 SUD 护理中，将近 40％的退伍军人在基线和随访时都对沟通和质量给予了最高评价。3 个月时的沟通评分与治疗中断有关，而 3 个月时的沟通和质量评分均与 SUD 症状和 3 个月时的心理健康独立相关。
这项研究初步支持将患者体验衡量标准，特别是提供者沟通评分纳入 SUD 护理的常规评估中。然而，在试点将此类措施纳入常规评估（例如在基于测量的护理中）之前，可能需要使用其他方法对提供者沟通评分的有效性进行进一步研究。
