JMIR Publications

ABSTRACT

Background:

Traditionally, treatment outcomes of service users with a substance use disorder (SUD) are measured using objective and provider-reported indicators. In recent years, there has been a shift towards incorporating Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) to capture service users' perspectives on treatment outcomes and experiences.

Objective:

The OMER-BE study (Outcome Measurement and Evaluation as a Routine practice in alcohol and other drug services in Belgium) aims to assess the acceptability and feasibility of PROMs and PREMs in different SUD treatment services, using the recently developed ICHOM Standard Set for Addictions. In this paper, we describe the design and baseline characteristics of the study, indicators of attrition at 45-day follow-up and the feasibility of the implementation of PROMs and PREMs in residential and outpatient services.

Methods:

A convenience sample of 189 treatment seeking individuals with SUD from different inpatient services (therapeutic communities, psychiatric centers) and outpatient treatment services is followed for six months. Sociodemographic characteristics, clinical factors and PROMs including recovery strengths, quality of life and global health were assessed at baseline, within 3 weeks after starting treatment. Additionally, PROMs and PREMs are measured 45, 90 and 180 days later. Comparisons were made between treatment modalities and indicators of attrition at the 45-day follow-up were assessed using ANOVA and Chi-square tests.

Results:

Baseline differences are observed between the three treatment modalities regarding education, SUD treatment history, primary substance and ADHD self-report scores. Overall, patients in PC are higher educated and have less polysubstance use, while outpatients have fewer previous SUD treatments but receive relatively more often opioid agonist treatment. Inpatients report more ADHD symptoms and higher SUD severity than outpatients. Additionally, recovery strength scores are found to be significantly lower in the outpatient group compared to the other groups, particularly in the subdomains of ‘Substance Use,’ ‘Self-care,’ and ‘Outlook on Life’. At the 45-day follow-up assessment, the attrition rate was 36.6%. Comparisons between participants who completed the 45-day follow-up and those who dropped out revealed that completers were significantly older, had a higher level of education, were more likely to live alone, and were more likely to have a mother born in Belgium. They had higher average scores on the ‘Material Resources’ domain of the SURE, which includes questions about stable housing, a steady income and effective financial management.

Conclusions:

Measuring PROMs and PREMs appears to be feasible in a diverse group of treatment seeking patients with SUD in Belgium. However, challenges remain for structural implementation in practice, especially in outpatient services. Routine monitoring of PROMs and PREMs has the potential to empower patients, service providers and policymakers by providing a comprehensive understanding of service users’ needs and treatment effectiveness.