Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST.
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 articleSubject
HumansSubstance-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
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https://hdl.handle.net/10161/19941Published Version (Please cite this version)
10.1016/j.jsat.2017.01.013Publication 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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Show full item recordScholars@Duke
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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