Robert P. Schwartz, MD
Friends Research Institute, Inc.
Li-Tzy Wu, ScD, RN
Duke Clinical Research Institute
Jennifer McNeely, MD
New York University
This study seeks the validation of a clinically useful brief screening and assessment instrument to identify patients with problematic substance use or a substance use disorder to facilitate brief interventions and referrals to appropriate treatment. Specifically, this study’s aims are to 1) develop a two-stage brief screening and assessment instrument to detect unhealthy use of tobacco, alcohol, prescription, and illicit drugs among primary care patients; 2) examine the validity of this 2-state instrument by comparing it to reference standard measures for substance use, problematic use, and substance use disorders; and 3) determine the feasibility of a self-administered 2-stage tool and an interviewer-administered 2-stage tool in US general medical settings.
Results found that the interviewer- and self-administered versions of the TAPS tool had similar diagnostic characteristics. For identifying problem use (at a cutoff of 1+), the TAPS tool had a sensitivity of 0.93 (95%CI, 0.90 to 0.95) and specificity of 0.87 (CI, 0.85 to 0.89) for tobacco and a sensitivity of 0.74 (CI, 0.70 to 0.78) and specificity of 0.79 (CI, 0.76 to 0.81) for alcohol. For problem use of illicit and prescription drugs, sensitivity ranged from 0.82 (CI, 0.76 to 0.87) for marijuana to 0.63 (CI, 0.47 to 0.78) for sedatives; specificity was 0.93 or higher. For identifying any SUD (at a cutoff of 2+), sensitivity was lower. This study supports the use of the TAPS tool (at a cutoff of 1+) in screening diverse populations of adult primary care patients for problem substance use. Although it may detect tobacco, alcohol, and marijuana use disorders, further refinement is needed before it can be recommended broadly for SUD screening.
Primary Outcomes Article: McNeely J, et al. Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients. Annals of Internal Medicine 2016 (in press). [get article]
All Participating Nodes: