Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients.

McNeely, Jennifer

Wu, Li-Tzy

Subramaniam, Geetha

Sharma, Gaurav

Cathers, Lauretta A

Svikis, Dace

Sleiter, Luke

Russell, Linnea

Nordeck, Courtney

Sharma, Anjalee

O'Grady, Kevin E

Bouk, Leah B

Cushing, Carol

King, Jacqueline

Wahle, Aimee

Schwartz, Robert P

United States

2016-12-01T18:42:13Z

2016-11-15

Background: Substance use, a leading cause of illness and death, is underidentified in medical practice. Objective: The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) tool was developed to address the need for a brief screening and assessment instrument that includes all commonly used substances and fits into clinical workflows. The goal of this study was to assess the performance of the TAPS tool in primary care patients. Design: Multisite study, conducted within the National Drug Abuse Treatment Clinical Trials Network, comparing the TAPS tool with a reference standard measure. (ClinicalTrials.gov: NCT02110693). Setting: 5 adult primary care clinics. Participants: 2000 adult patients consecutively recruited from clinic waiting areas. Measurements: Interviewer- and self-administered versions of the TAPS tool were compared with a reference standard, the modified World Mental Health Composite International Diagnostic Interview (CIDI), which measures problem use and substance use disorder (SUD). Results: 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. Limitations: The low prevalence of some drug classes led to poor precision in some estimates. Research assistants were not blinded to participants' TAPS tool responses when they administered the CIDI. Conclusion: In a diverse population of adult primary care patients, the TAPS tool detected clinically relevant problem substance use. Although it also may detect tobacco, alcohol, and marijuana use disorders, further refinement is needed before it can be recommended broadly for SUD screening. Primary Funding Source: National Institute on Drug Abuse.

http://www.ncbi.nlm.nih.gov/pubmed/27595276

2546703

1539-3704

https://hdl.handle.net/10161/13079

eng

American College of Physicians

Ann Intern Med

10.7326/M16-0317

Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients.

Journal article

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

http://www.ncbi.nlm.nih.gov/pubmed/27595276

690

699

10

Center for Child and Family Policy

Clinical Science Departments

Duke

Duke Clinical Research Institute

Duke Institute for Brain Sciences

Institutes and Centers

Institutes and Provost's Academic Units

Medicine

Medicine, General Internal Medicine

Psychiatry & Behavioral Sciences

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Sanford School of Public Policy

School of Medicine

University Institutes and Centers

Published

165