“There Are Things I Want to Say But You Do Not Ask”: a Comparison Between Standardised and Individualised Evaluations in Substance Use Treatment

Abstract

There has been an increasing call for service users to be more actively involved with the evaluation of treatment outcomes. One strategy to impove such involvement is to ask service users to contribute with their own criteria for evaluation by sharing their personal story and perspective about their clinical situation. In this cross-sectional study, we contrasted the contents elicited by service users completing two individualised measures against the contents of three widely used standardised measures. We also compared two methods to generate individualised data using self-report and interview-based instruments (PSYCHLOPS and PQ). Following a thematic comparison approach, we found that one quarter of the problems reported by patients in individualised measures were not covered by any of our standardised comparators. Also, half of our sample generated at least one problem whose theme was not covered by any of the three standardised measures. We also found that patients in this population have many other concerns beyond drug use. These included psychological (e.g. interpersonal relationships) and socio-economic (e.g. money) problems, which were frequently reported. Our study suggests that listening to service users' stories allows us to capture issues of importance to service users in substance use treatment, which may be underestimated by standardised measures.

Exploring the use of individualised patient‐reported outcome measures in eating disorders: Validation of the Psychological Outcome Profiles

“…This result is similar to Alves et al. (2020), which found that almost half (49%) of the participants seeking treatment for substance abuse identified a key problem or difficulty not measured by three standardised PROMs: the CORE‐OM, The Patient Health Questionnaire‐9 (PHQ‐9; Kroenke, Spitzer, & Williams, 2001) and the substance‐use‐specific Treatment Outcomes Profile (TOP; Marsden et al., 2008). However, our findings were less pronounced than previous work by Sales et al.…”

“…However, in contrast to our study and that of Alves et al. (2020), only two PROMs were used for comparison, neither of which was disease specific. It appears that, as the number of PROMs increases, and with the inclusion of both universal PROMs (e.g., CORE‐OM, PHQ‐9) and disease‐specific PROMs (e.g., EDE‐Q, TOP), the number of unique concerns identified by the PSYCHLOPS decreases.…”

“…The PSYCHLOPS has now moved beyond primary healthcare settings, with recent studies assessing its efficacy in specialist services providing psychological therapies for a range of psychiatric disorders, including psychosis (Kelly, Holttum, Evans, & Shepherd, 2012), substance abuse disorder (Alves, Sales, Ashworth, & Faísca, 2020) and post‐traumatic stress disorder (BuddeAkko & AinamiMurillo‐Rodriguez, 2018). Based on the empirical evidence obtained in these areas, we hypothesise that the PSYCHLOPs will be suitable for uncovering additional patient concerns in individuals receiving psychological therapy for an ED.…”

Measuring psychological outcomes in paediatric settings: Making outcomes meaningful using client-defined perspectives

“…Measuring outcomes must be of clinical utility and not just a tick-box process (Wolpert et al, 2014). Clinical judgement in the type of measurement which may suit and be useful for work with the individual is key and the advice is to use client-defined measures alongside other measures of outcome (Alves et al, 2018; Green, 2016; Wolpert et al, 2014). Training in the process of measuring outcomes and how to use them to enhance SDM may be of as much importance, if not more, as deciding which outcome measures to use.…”

“…Moreover, there is also some research which suggests that goal-based outcome measures may align more to functioning aspects of personal change, as opposed to symptomatology, thus further suggesting that they may be most appropriately used alongside other measures of outcome (Jacob, Edbrooke-Childs, et al, 2017). Indeed, the use of both broad, standardised measures and personalised outcome measures is encouraged to ensure that a breadth of information is considered (Alves et al, 2018; Green, 2016; Wolpert et al, 2014). This also links to research which suggests that the clinical utility of outcome measurement is of most importance and the mindful use of outcome measures is key to their use (Wolpert et al, 2014).…”