Measuring recovery in opioid use disorder: clinical utility and psychometric properties of the Treatment Effectiveness Assessment

• Main Authors: Ling W (Author), Nadipelli VR (Author), Solem CT (Author), Farabee D (Author), Ronquest NA (Author), Perrochet B (Author), Learned SM (Author), Deshpande CG (Author), Heidbreder C (Author)
• Format: Book
• Published: Dove Medical Press, 2019-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Walter Ling,1 Vijay R Nadipelli,2 Caitlyn T Solem,3 David Farabee,1,4 Naoko A Ronquest,2 Brian Perrochet,1,5 Susan M Learned,6 Chinmay G Deshpande,3 Christian Heidbreder71UCLA Department of Family Medicine, Center for Behavioral and Addiction Medicine, Los Angeles, CA, USA; 2Global Health Economics and Outcomes Research, Indivior Inc, Richmond, VA, USA; 3Patient-centered outcomes Center of Excellence, Pharmerit International, Bethesda, ML, USA; 4Department of Population Health, School of Medicine,, New York, NY, USA; 5Marron Institute of Urban Management, Marron Institute, New York University, New York, NY, USA; 6Global Medicines Development, Indivior Inc, Richmond, VA, USA; 7Global Research and Development, Indivior Inc, Richmond, VA, USAPurpose: The Treatment Effectiveness Assessment (TEA) is a patient-centered instrument for evaluating treatment progress and recovery from substance use disorders, including opioid use disorder (OUD). We assessed the TEA&rsquo;s reliability and validity and determined minimal clinically important differences (MIDs) in participants with moderate to severe OUD.Patients and methods: The TEA measures change in four single-item domains (substance use, health, lifestyle, community involvement) from treatment initiation across the duration of a treatment program. Self-reported responses range from 1 (&ldquo;none or not much&rdquo;) to 10 (&ldquo;much better&rdquo;) with items summed to a total score ranging from 4&ndash;40. We assessed floor and ceiling effects, internal consistency, test-retest reliability, known-groups validity (ANOVA stratified by current health status [36-Item Short Form Health Survey item 1]), convergent/divergent validity, and MIDs using data from a phase 3, open-label clinical trial of buprenorphine extended-release monthly injection for subcutaneous use (BUP-XR). Participants with OUD completed the TEA at screening and before monthly injections for up to 12 months.Results: Among 410 participants (mean age 38 years; 64% male), the mean baseline (pre-injection 1) TEA total score was 25.4 (SD 9.7), with <10% of participants at the measure floor and 10%&ndash;20% at the ceiling across domains. Internal consistency was high (Cronbach&rsquo;s &alpha;=0.90), with marginal test-retest reliability (intraclass correlation coefficient =0.69). Mean TEA total score consistently increased from baseline (n=410; mean 25.4 [SD 9.7]) to end of study (n=337; 35.0 [6.7]) and differentiated between current health status groups (P<0.001); it was weakly correlated with other measures of health-related quality of life/severity. MIDs ranged from 5&ndash;8 for the TEA total score across anchor- and distribution-based approaches.Conclusion: The TEA exhibited acceptable reliability and validity in a cohort of participants with moderate to severe OUD treated with BUP-XR. Given its brevity and psychometric properties, the TEA is a promising tool for use in clinical practice and research.Keywords: Treatment Effectiveness Assessment, TEA, opioid use disorder, patient-reported outcomes, addiction, psychometrics

Item Description

1179-8467