Han Benjamin H, Palamar Joseph J, Moore Alison A, Schwartz Robert P, Wu Li-Tzy, Subramaniam Geetha, McNeely Jennifer
From the Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego, La Jolla, CA (BHH, AAM); Department of Population Health, Section on Alcohol, Tobacco, and Drug Use, New York University Grossman School of Medicine, New York, NY (JJP, JMN); Friends Research Institute, Baltimore, MD (RPS); Duke University School of Medicine, Durham, NC (L-TW); and National Institute on Drug Abuse, Rockville, MD (GS).
J Addict Med. 2025;19(1):109-111. doi: 10.1097/ADM.0000000000001363.
This analysis evaluated the validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool for older adults.
We performed a subgroup analysis of older adults aged ≥65 (n = 184) from the TAPS tool validation study conducted in 5 primary care clinics. We compared the interviewer and self-administered versions of the TAPS tool at a cutoff of ≥1 for identifying problem use with a reference standard measure, the modified World Mental Health Composite International Diagnostic Interview.
The mean age was 70.6 ± 5.9 years, 52.7% were female, and 49.5% were non-Hispanic Black. For identifying problem use, the self-administered TAPS tool had sensitivity of 0.91 (95% CI: 0.75-0.98) and specificity of 0.91 (95% CI: 0.85-0.95) for tobacco; sensitivity of 0.68 (95% CI: 0.45-0.86) and specificity of 0.88 (95% CI: 0.82-0.93) for alcohol; and sensitivity 0.86 (95% CI: 0.42-1.00) and specificity 0.94 (95% CI: 0.90-0.97) for cannabis. The interviewer-administered TAPS tool had similar results. We were unable to evaluate its performance for identifying problem use of individual classes of drugs other than cannabis in this population due to small sample sizes.
While the TAPS had excellent sensitivity and specificity for identifying tobacco use among older adults, the results for other substances lack precision, and we were unable to evaluate its performance for prescription medications and individual illicit drugs in this sample. This analysis underlines the critical need to adapt and validate screening tools for unhealthy substance use, specifically for older populations who have unique risks.
本分析评估了老年人烟草、酒精、处方药及其他物质使用（TAPS）工具的验证结果。
我们对在5家初级保健诊所进行的TAPS工具验证研究中年龄≥65岁的老年人（n = 184）进行了亚组分析。我们将TAPS工具的访谈者施测版和自我施测版在识别问题使用方面的截断值设为≥1，并与参考标准测量方法——改良的世界心理健康综合国际诊断访谈进行比较。
平均年龄为70.6±5.9岁，52.7%为女性，49.5%为非西班牙裔黑人。在识别问题使用方面，自我施测的TAPS工具对烟草的敏感性为0.91（95%置信区间：0.75 - 0.98），特异性为0.91（95%置信区间：0.85 - 0.95）；对酒精的敏感性为0.68（95%置信区间：0.45 - 0.86），特异性为0.88（95%置信区间：0.82 - 0.93）；对大麻的敏感性为0.86（95%置信区间：0.42 - 1.00），特异性为0.94（95%置信区间：0.90 - 0.97）。访谈者施测的TAPS工具也有类似结果。由于样本量小，我们无法评估该工具在该人群中识别除大麻外其他各类药物问题使用的性能。
虽然TAPS在识别老年人烟草使用方面具有出色的敏感性和特异性，但对其他物质的结果缺乏精确性，且我们无法评估其在该样本中对处方药和个别非法药物的性能。本分析强调了迫切需要调整和验证针对不健康物质使用的筛查工具，特别是针对有独特风险的老年人群。
