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Identifying Substance Misuse in Primary Care: TAPS Tool Compared to the WHO ASSIST.

Journal of Substance Abuse Treatment 2017 (in press). [doi: 10.1016/j.jsat.2017.01.013]

Robert P. Schwartz, MD (Friends Research Institute, MA Node), Jennifer McNeely, MD, MS (New York University, GNY Node), Li-Tzy Wu, ScD (Duke University, MS Node), Gaurav Sharma, PhD (CTN Data & Statistics Center, Emmes), Aimee Wahle, MS (CTN Data & Statistics Center, Emmes), Carol Cushing, BBA, RN (NIDA Center for the Clinical Trials Network), Courtney Nordeck (Friends Research Institute, MA Node), Anjalee Sharma, MSW (Friends Research Institute, MA Node), Kevin E. O'Grady, PhD (University of Maryland), Jan Gryczynski, MA (Friends Research Institute, MA Node), Shannon G. Mitchell, PhD (Friends Research Institute, MA Node), Robert L. Ali, MD (University of Adelaide, Australia), John Marsden, BSc, MSc, PhD (King's College London), Geetha A. Subramaniam, MD (NIDA Center for the Clinical Trials Network).

There is a need for screening and brief assessment instruments to identify primary care patients with substance use problems. This study's aim was to examine the performance of a two-step screening and brief assessment instrument, the TAPS Tool, compared to the WHO ASSIST. Two thousand adult primary care patients recruited from five primary care clinics in four Eastern US states completed the TAPS Tool followed by the ASSIST. The ability of the TAPS Tool to identify moderate- and high-risk use scores on the ASSIST was examined using sensitivity and specificity analyses.

The interviewer and self-administered computer tablet versions of the TAPS Tool generated similar results. The interviewer-administered version (at cut-off of 2) had acceptable sensitivity and specificity for high-risk tobacco (0.90 and 0.77) and alcohol (0.87 and 0.80) use. For illicit drugs, sensitivities were >0.82 and specificities >0.92. The TAPS (at cut-off of 1) had good sensitivity and specificity for moderate-risk tobacco use (0.83 and 0.97) and alcohol (0.83 and 0.74). Among illicit drugs, sensitivity was acceptable for moderate-risk of marijuana (0.71), while it was low for all other illicit drugs and non-medical use of prescription medications. Specificities were 0.87 or higher for all illicit drugs and prescription medications.

Conclusions: The TAPS Tool identified adult primary care patients with high-risk ASSIST scores for all substances as well as moderate-risk users of tobacco, alcohol, and marijuana, although it did not perform well in identifying patients with moderate-risk use of other drugs or non-medical use of prescription medications. The advantages of the TAPS Tool over the ASSIST are its more limited number of items and focus solely on substance use in the past 3 months. The TAPS Tool score provides the primary care physician with a window into current drug use and problems, and is an alternative to the longer version of the ASSIST. (Article (Peer-Reviewed), PDF, English, 2017)

Keywords: Alcohol | Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | CTN platform/ancillary study | Marijuana | Prescription-type opiates | Primary care | Screening and assessment instruments | Smoking | Tobacco, Alcohol, Prescription Medication, and Other Substance Use Tool (TAPS Tool) | Journal of Substance Abuse Treatment (journal)

Document No: 1253, PMID: 28159441, PMCID: PMC5377907.

Submitted by the CTN Dissemination Librarians (2/8/2017).

Ali, Robert L.
Cushing, Carol
Gryczynski, Jan
Marsden, John
McNeely, Jennifer mail
Mitchell, Shannon G.
Nordeck, Courtney
O'Grady, Kevin E.
Schwartz, Robert P. mail
Sharma, Anjalee
Sharma, Gaurav mail
Subramaniam, Geetha A. mail
Wahle, Aimee mail
Wu, Li-Tzy mail
NIDA-CTN-0059 www
Mid-Atlantic www
Greater New York www
Southern Consortium www

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