An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders

Nicola Black; Sophie Chung; Calvert Tisdale; Luz Sousa Fialho; Apinun Aramrattana; Sawitri Assanangkornchai; Alex Blaszczynski; Henrietta Bowden-Jones; Wim van den Brink; Adrian Brown; Qiana L Brown; Linda B Cottler; Maury Elsasser; Marica Ferri; Maria Florence; Ralitza Gueorguieva; Ryan Hampton; Suzie Hudson; Peter J Kelly; Nicholas Lintzeris; Lynette Murphy; Abhijit Nadkarni; Joanne Neale; Daniel Rosen; Hans-Jürgen Rumpf; Brian Rush; Gabriel Segal; Gillian W Shorter; Marta Torrens; Christopher Wait; Katherine Young; Michael Farrell

doi:10.3390/jcm13072154

An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders

J Clin Med. 2024 Apr 8;13(7):2154. doi: 10.3390/jcm13072154.

Authors

Nicola Black¹, Sophie Chung², Calvert Tisdale¹, Luz Sousa Fialho², Apinun Aramrattana³, Sawitri Assanangkornchai⁴, Alex Blaszczynski⁵, Henrietta Bowden-Jones^{6

7}, Wim van den Brink⁸, Adrian Brown⁹, Qiana L Brown¹⁰, Linda B Cottler¹¹, Maury Elsasser¹², Marica Ferri¹³, Maria Florence¹⁴, Ralitza Gueorguieva¹⁵, Ryan Hampton¹⁶, Suzie Hudson¹⁷, Peter J Kelly¹⁸, Nicholas Lintzeris¹⁹, Lynette Murphy²⁰, Abhijit Nadkarni^{21

22}, Joanne Neale²³, Daniel Rosen²⁴, Hans-Jürgen Rumpf²⁵, Brian Rush²⁶, Gabriel Segal²⁷, Gillian W Shorter^{28

29}, Marta Torrens³⁰, Christopher Wait³¹, Katherine Young², Michael Farrell¹

Affiliations

¹ National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia.
² International Consortium for Health Outcomes Measurement, London W12 8EU, UK.
³ Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
⁴ Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
⁵ School of Psychology, Brain and Mind Centre, Faculty of Science, University of Sydney, Sydney 2006, Australia.
⁶ Department of Psychiatry, University College London, London NW1 2AE, UK.
⁷ Department of Psychiatry, Cambridge University, Cambridge CB2 1QW, UK.
⁸ Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
⁹ Northwick Park Hospital, Central and North West London Trust, London HA1 3UJ, UK.
¹⁰ School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
¹¹ Department of Epidemiology, College of Medicine & Public Health and Health Professions, University of Florida, Homestead, FL 33031, USA.
¹² Independent Researcher, South Berwick, ME 03908, USA.
¹³ Department of Psychology, Faculty of Community and Health, European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal.
¹⁴ Department of Biostatistics, School of Public Health, University of the Western Cape, Cape Town 7535, South Africa.
¹⁵ Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06511, USA.
¹⁶ The Voices Project, Las Vegas, NV 89149, USA.
¹⁷ Network of Alcohol and Other Drugs Agencies, Sydney 2751, Australia.
¹⁸ Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, Australia.
¹⁹ Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia.
²⁰ Independent Researcher, Sydney 2000, Australia.
²¹ Addictions and Related Research Group, Sangath, Bardez 403501, Goa, India.
²² Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
²³ Addictions Department, King's College London, London SE1 9NH, UK.
²⁴ School of Social Work, University of Pittsburgh, Pittsburgh, PA 15213, USA.
²⁵ Translational Psychiatry Unit, Universität zu Lübeck, 23562 Lübeck, Germany.
²⁶ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
²⁷ Department of Philosophy, King's College London, London SE1 9NH, UK.
²⁸ Drug and Alcohol Research Network, School of Psychology, Queen's University Belfast, Belfast BT9 5AJ, UK.
²⁹ Institute of Mental Health Sciences, Ulster University, Coleraine BT52 1SA, UK.
³⁰ Addiction Service, Hospital del Mar, 08003 Barcelona, Spain.
³¹ Build on Belief, London SW5 9HB, UK.

Abstract

Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.

Keywords: Delphi; ICHOM; addiction; addictive disorders; consensus set; core outcome set; gambling disorder; gaming disorder; outcome measures; patient-centered; substance use.

Abstract

Grants and funding