Towards a genuinely user-centred evaluation of harm reduction and drug treatment programmes: A further proposal

Trujols, Joan; Iraurgi, Ioseba; Batlle, Francesca; Duran-Sindreu, Santiago; Cobos, José Pérez de los

doi:10.1016/j.drugpo.2015.08.012

Cited by 13 publications

(22 citation statements)

References 25 publications

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“…There has been a recent call for the use of individualised data in the evaluation of substance use disorder treatment [ 18 , 21 , 22 ]. Such data can be collected with individualised measures, which are tailor-made lists of items (problems or goals), generated in patients’ own words [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

“It is not just about the alcohol”: service users’ views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence

Alves

Sales

Ashworth

2016

Subst Abuse Treat Prev Policy

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BackgroundThe involvement of service users in health care provision in general, and specifically in substance use disorder treatment, is of growing importance. This paper explores the views of patients in a therapeutic community for alcohol dependence about clinical assessment, including general aspects about the evaluation process, and the specific characteristics of four measures: two individualised and two standardised.MethodsA focus group was conducted and data were analysed using a framework synthesis approach.ResultsService users welcomed the experience of clinical assessment, particularly when conducted by therapists. The duration of the evaluation process was seen as satisfactory and most of its contents were regarded as relevant for their population. Regarding the evaluation measures, patients diverged in their preferences for delivery formats (self-report vs. interview). Service users enjoyed the freedom given by individualised measures to discuss topics of their own choosing. However, they felt that part of the standardised questions were difficult to answer, inadequate (e.g. quantification of health status in 0–20 points) and sensitive (e.g. suicide-related issues), particularly for pre-treatment assessments.ConclusionsPatients perceived clinical assessment as helpful for their therapeutic journey, including the opportunity to reflect about their problems, either related or unrelated to alcohol use. Our study suggests that patients prefer to have evaluation protocols administered by therapists, and that measures should ideally be flexible in their formats to accommodate for patient preferences and needs during the evaluation.

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Section: Introductionmentioning

confidence: 99%

“It is not just about the alcohol”: service users’ views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence

Alves

Sales

Ashworth

2016

Subst Abuse Treat Prev Policy

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“…A growing body of literature suggests that personalising the assessment of outcome in substance use treatment is of central importance (Alves et al 2015;Trujols et al 2015). Recent reports have also shown that patients in this population appreciate being actively engaged in outcome assessment .…”

Section: Introductionmentioning

confidence: 99%

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

Alves

Sales

Ashworth

et al. 2018

Int J Ment Health Addiction

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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.

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“…El cinquè article (Trujols, Iraurgi, Batlle, Duran-Sindreu & Pérez de los Cobos, 2015) vol servir de crida per a una avaluació dels TMM o de qualsevol modalitat de tractament en l'àmbit de les addiccions, veritablement rellevant des de la perspectiva de les persones ateses. S'emfatitza la necessitat de desenvolupar i incloure en els estudis d'efectivitat MRCP realment orientades als usuaris o pacients (MRCP-GP i MRCP-CP), amb l'objectiu que en el ventall d'instruments utilitzats hi hagi un equilibri entre els instruments desenvolupats de manera habitual -és a dir, amb una participació limitada dels pacients-i les MRCP dissenyades amb metodologies veritablement participatives o, fins i tot, mitjançant estudis liderats pels pacients mateixos (Rose, Evans, Sweeney & Wykes, 2011;Vayena et al, 2016).…”

Section: Crida Per a Una Avaluació De Resultats Realment Centrada Enunclassified

Aproximacions a la perspectiva de la persona en tractament de manteniment amb metadona: Reflexions a propòsit de 10 anys de recerca / Approaches to the perspective of the individual receiving methadone maintenance treatment: Reflections on 10 years of research

Trujols

Guàrdia‐Olmos

Iraugui

et al. 2017

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Resum. Els tractaments de manteniment amb metadona (TMM) són un autèntic tractament psicofarmacològic de la dependència d’heroïna i, a la vegada, un element indispensable de les polítiques i les intervencions de reducció de danys. L’efectivitat dels TMM ha estat avaluada, gairebé de manera exclusiva, mitjançant la utilització d’indicadors anomenats durs. Intentant anar més enllà d’aquest enfocament tradicional, hem portat a terme, durant els darrers 10 anys, diversos estudis emprírics i assaigs teòrics que s’emmarquen dins d’un objectiu global de generar coneixement al voltant de –i amb– la perspectiva de la persona en TMM. En aquest article, resumim de manera selectiva les troballes més rellevants d’aquesta línia de recerca per discutir després algunes de les seves principals implicacions. Finalment, abordem alguns dels reptes –i suggerim alguns dels canvis necessaris– per a una avaluació dels TMM realment centrada en el pacient.Summary. Methadone maintenance treatment (MMT) is both a specific psychopharmacological treatment of heroin dependence and a core harm-reduction intervention. Over the last 10 years we have been working to break the mould of the traditional focus on the so-called hard indicators of MMT effectiveness, pursuing instead a line of research that makes room for the consideration of the perspectives of methadone-maintained patients, resulting in several empirical and theoretical papers. Firstly, this commentary briefly and selectively summarizes some key findings from five of these papers. It then discusses the main implications of these findings. Finally, it addresses some of the challenges involved in conducting a genuinely patient-centred evaluation of MMT, along with some of the changes that would be required to accomplish this.

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Towards a genuinely user-centred evaluation of harm reduction and drug treatment programmes: A further proposal

Cited by 13 publications

References 25 publications

“It is not just about the alcohol”: service users’ views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence

“It is not just about the alcohol”: service users’ views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence

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

Aproximacions a la perspectiva de la persona en tractament de manteniment amb metadona: Reflexions a propòsit de 10 anys de recerca / Approaches to the perspective of the individual receiving methadone maintenance treatment: Reflections on 10 years of research

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