Validation of the TAPS-1: A Four-Item Screening Tool to Identify Unhealthy Substance Use in Primary Care.

Gryczynski, Jan

McNeely, Jennifer

Wu, Li-Tzy

Subramaniam, Geetha A

Svikis, Dace S

Cathers, Lauretta A

Sharma, Gaurav

King, Jacqueline

Jelstrom, Eve

Nordeck, Courtney D

Sharma, Anjalee

Mitchell, Shannon G

O'Grady, Kevin E

Schwartz, Robert P

2020-02-03T04:10:46Z

2020-02-03T04:10:46Z

2017-09

2020-02-03T04:10:45Z

BACKGROUND:The Tobacco, Alcohol, Prescription Medication, and Other Substance use (TAPS) tool is a combined two-part screening and brief assessment developed for adult primary care patients. The tool's first-stage screening component (TAPS-1) consists of four items asking about past 12-month use for four substance categories, with response options of never, less than monthly, monthly, weekly, and daily or almost daily. OBJECTIVE:To validate the TAPS-1 in primary care patients. DESIGN:Participants completed the TAPS tool in self- and interviewer-administered formats, in random order. In this secondary analysis, the TAPS-1 was evaluated against DSM-5 substance use disorder (SUD) criteria to determine optimal cut-points for identifying unhealthy substance use at three severity levels (problem use, mild SUD, and moderate-to-severe SUD). PARTICIPANTS:Two thousand adult patients at five primary care sites. MAIN MEASURES:DSM-5 SUD criteria were determined via the modified Composite International Diagnostic Interview. Oral fluid was used as a biomarker of recent drug use. KEY RESULTS:Optimal frequency-of-use cut-points on the self-administered TAPS-1 for identifying SUDs were ≥ monthly use for tobacco and alcohol (sensitivity = 0.92 and 0.71, specificity = 0.80 and 0.85, AUC = 0.86 and 0.78, respectively) and any reported use for illicit drugs and prescription medication misuse (sensitivity = 0.93 and 0.89, specificity = 0.85 and 0.91, AUC = 0.89 and 0.90, respectively). The performance of the interviewer-administered format was similar. When administered first, the self-administered format yielded higher disclosure rates for past 12-month alcohol use, illicit drug use, and prescription medication misuse. Frequency of use alone did not provide sufficient information to discriminate between gradations of substance use problem severity. Among those who denied drug use on the TAPS-1, less than 4% had a drug-positive biomarker. CONCLUSIONS:The TAPS-1 can identify unhealthy substance use in primary care patients with a high level of accuracy, and may have utility in primary care for rapid triage.

10.1007/s11606-017-4079-x

0884-8734

1525-1497

https://hdl.handle.net/10161/19938

eng

Springer Science and Business Media LLC

Journal of general internal medicine

10.1007/s11606-017-4079-x

Humans

Substance-Related Disorders

Mass Screening

Disclosure

Alcohol Drinking

Adult

Primary Health Care

Female

Drug Users

Tobacco Products

Surveys and Questionnaires

Validation of the TAPS-1: A Four-Item Screening Tool to Identify Unhealthy Substance Use in Primary Care.

Journal article

Wu, Li-Tzy|0000-0002-5909-2259

990

996

9

School of Medicine

Duke

Center for Child and Family Policy

Sanford School of Public Policy

Duke Clinical Research Institute

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Psychiatry & Behavioral Sciences

Clinical Science Departments

Medicine, General Internal Medicine

Medicine

Published

32