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Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST.

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Date
2017-05
Authors
Schwartz, RP
McNeely, J
Wu, LT
Sharma, G
Wahle, A
Cushing, C
Nordeck, CD
Sharma, A
O'Grady, KE
Gryczynski, J
Mitchell, SG
Ali, RL
Marsden, J
Subramaniam, GA
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Abstract
There is a need for screening and brief assessment instruments to identify primary care patients with substance use problems. This study's aim was to examine the performance of a two-step screening and brief assessment instrument, the TAPS Tool, compared to the WHO ASSIST.Two thousand adult primary care patients recruited from five primary care clinics in four Eastern US states completed the TAPS Tool followed by the ASSIST. The ability of the TAPS Tool to identify moderate- and high-risk use scores on the ASSIST was examined using sensitivity and specificity analyses.The interviewer and self-administered computer tablet versions of the TAPS Tool generated similar results. The interviewer-administered version (at cut-off of 2), had acceptable sensitivity and specificity for high-risk tobacco (0.90 and 0.77) and alcohol (0.87 and 0.80) use. For illicit drugs, sensitivities were >0.82 and specificities >0.92. The TAPS (at a cut-off of 1) had good sensitivity and specificity for moderate-risk tobacco use (0.83 and 0.97) and alcohol (0.83 and 0.74). Among illicit drugs, sensitivity was acceptable for moderate-risk of marijuana (0.71), while it was low for all other illicit drugs and non-medical use of prescription medications. Specificities were 0.97 or higher for all illicit drugs and prescription medications.The TAPS Tool identified adult primary care patients with high-risk ASSIST scores for all substances as well moderate-risk users of tobacco, alcohol, and marijuana, although it did not perform well in identifying patients with moderate-risk use of other drugs or non-medical use of prescription medications. The advantages of the TAPS Tool over the ASSIST are its more limited number of items and focus solely on substance use in the past 3months.
Type
Journal article
Subject
Humans
Substance-Related Disorders
Alcoholism
Tobacco Use Disorder
Mass Screening
Sensitivity and Specificity
Reproducibility of Results
Substance Abuse Detection
Marijuana Smoking
Interview, Psychological
Adult
Aged
Middle Aged
Primary Health Care
Female
Male
Prescription Drug Misuse
Surveys and Questionnaires
Permalink
https://hdl.handle.net/10161/19941
Published Version (Please cite this version)
10.1016/j.jsat.2017.01.013
Publication Info
Schwartz, RP; McNeely, J; Wu, LT; Sharma, G; Wahle, A; Cushing, C; ... Subramaniam, GA (2017). Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST. Journal of substance abuse treatment, 76. pp. 69-76. 10.1016/j.jsat.2017.01.013. Retrieved from https://hdl.handle.net/10161/19941.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Wu

Li-Tzy Wu

Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder
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