A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers.

Protocol CTN-0016 (“Patient Feedback: A Performance Improvement Study in Outpatient Addiction Treatment”) examined the feasibility of the implementation of a semiautomatic performance improvement system directed at clinicians in addiction treatment facilities called “patient feedback.” The study found that implementation of the program was generally feasible from both a research and a clinical perspective. This article reports on the results of a randomized, controlled trial evaluating the actual efficacy of the patient feedback system. The study involved 118 clinicians working at 20 community-based outpatient substance abuse treatment clinics in the northeastern United States (including some CTPs from the CTN). Ten clinics received 12 weeks of the patient feedback performance improvement intervention, and 10 clinics received no intervention during the 12 weeks. More than 1,500 patients provided anonymous ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use. There was no evidence of an intervention effect on the primary drug and alcohol use scales. There was also no evidence of an intervention effect on secondary measures of therapeutic alliance. Clinician-rated measures of organizational functioning and job satisfaction also showed no intervention effect. Possible insights from these findings and alternative methods of utilizing feedback reports to enhance clinical outcomes are proposed.

Related protocols: CTN-0016