American Journal of Drug and Alcohol Abuse 2011;37(5):358-366. [doi: 10.3109/00952990.2011.602997]
Jeffrey E. Korte, MD, Kathryn M. Magruder, PhD, MPH, Codruta C. Chiuzan, MS, Sarah L. Logan, MS, Therese Killeen, PhD, APRN, Dipankar Bandyopadhyay, PhD, Kathleen T. Brady, MD, PhD (all from Medical University of South Carolina, SC Node).
Selection of appropriate outcome measures is important for clinical studies of drug addiction treatment. Researchers use various methods for collecting drug use outcomes and must consider substances to be included in a urine drug screen (UDS), accuracy of self-report, use of various instruments and procedures for collecting self-reported drug use, and timing of outcome assessments. This study sought to define a set of candidate measures to (1) assess their intercorrelation and (2) identify any differences in results. To that end, data were combined from seven completed protocols in the National Drug Abuse Treatment Clinical Trials Network (CTN), with a total of 1897 participants. Nine outcome measures were defined, based on UDS, self-report, or a combination, then multivariable, multilevel generalized estimating equation models were used to assess subgroup differences in intervention success, controlling for baseline differences and accounting for clustering by CTN protocols. Results found high correlations among all candidate outcomes. All outcomes showed consistent overall results with no significant intervention impact on drug use during follow-up. However, with most UDS variables, but not with self-report or "corrected self-report," a significant gender–ethnicity interaction with benefit shown in African American women, White women, and Hispanic men was observed.
Conclusions: Despite strong associations between candidate measures, important differences in results were found. This study demonstrates the potential utility and impact of combining UDS and self-report data for drug use assessment. The results suggest possible differences in intervention efficacy by gender and ethnicity, but highlight the need to cautiously interpret observed interactions. Additional studies like this one will help guide implementation of methodological recommendations to construct combined measures. (Article (Peer-Reviewed), PDF, English, 2011)
Keywords: Addiction Severity Index (ASI) | African Americans | Amphetamines | Behavior therapy | Cocaine | Gender differences | Hispanics and Latinos | Marijuana | Methamphetamine | Minority gruops | Motivational incentives | Motivational interviewing (MI) | Opioid dependence | Outcomes evaluation | Pharmacological therapy | Prescription-type opiates | Screening and assessment instruments | Statistical analysis | Stimulant abuse | Urinalysis | Urine Drug Screen (UDS) | Women | American Journal of Drug and Alcohol Abuse (journal)
Document No: 734, PMID: 21854278, PMCID: PMC3164549.
Submitted by CTN Dissemination Librarians, 8/23/2011.