Alcohol and Drug Outcome measure (ADOM)

Transcription

1 Alcohol and Drug Outcome measure (ADOM) One year of data, what have we learnt? Paul Hanton, Clinical Project Lead BA (Hons), MA, Reg. MBACP (Accred)

2 Some background ADOM is a self rated (tangata whai ora) outcome measure covering three domains: alcohol and other drug use; frequency and amounts lifestyle and well being recovery (designed by tangata whai ora). ADOM was nine years in preparation, design and testing.

3 There are some ADOM forms on your seats.

4 Background continued ADOM implementation team (train the trainers) ADOM was mandated for use in adult, outpatient community teams from 1 July 2015 ADOM pages on Te Pou website post implementation support - practitioners guide, videos, emessage group reports advisory group.

5 Background continued Report capture data from 77 mandated services, both District Health Boards (DHBs) and Non-government Organisations (NGOs), comprising of 237 eligible teams. First report in December 2016 captured initial data. Second report, May 2017 captured data from 80% (approx.) of eligible teams. Report has an executive summary and 47 pages of information.

6 The data captured in numbers: October 2015 to September ,096 total AOD referral into PRIMHD 22,607 referrals opened into mandated ADOM services 7,037 valid ADOM treatment start collections 885 Matched pairs (treatment start and treatment end) Whilst there were a number of pieces of information gleaned at treatment start collections, such as detail on substances of main concern, this presentation will focus on the matched pairs. Intent and purpose of ADOM is not data collection per se.

7 Question Start mean End mean Q1: Alcohol days of use 9.0 (n=596) 4.3 (n=596) Outcome (Start minus end mean) Cohen's d (effect size with 95% CI) Effect of treatment ( ) Medium Alcohol and other dug use frequency and amounts - treatment start to treatment finish Q2: Alcohol number of standard drinks consumed in a typical days use Q3: Cannabis number of days Q4: Amphetamine-type stimulant number of days 10.7 (n=582) 12.0 (n=263) 5.9 (n=579) 5.9 (n=261) ( ) Medium ( ) Medium 9.4 (n=91) 2.4 (n=91) ( ) Large Q5: Opioid number of days 15.6 (n=20) 1.0 (n=20) ( ) Large There is a recognition that opioid and sedative are small sample sizes, these will grow with accumulated data. Q6: Sedatives/tranquilisers number of days 14.7 (n=28) 2.8 (n=28) ( ) Large Q8: Cigarettes - number smoked on average per day 12.4 (n=549) 10.4 (n=535) ( ) Small Q10: Number of days injecting drugs 12.6 (n=21) 1.1 (n=21) ( ) Large

8 Graph 41: Distribution in lifestyle and wellbeing for ADOM treatment start and end for matched pairs, amphetamine-type stimulants main substance of concern at treatment start, October September 2016 We have been able to show outcomes by ethnicity, age demographic, substance of concern, gender and individual outcome question. It is possible to breakdown by DHB, NGO, area etc. and we may do this is custom reports.

9 So, what have we learnt so far? Amphetamine-type stimulants are showing effects in relation to housing and criminal activity. The treatment start collections give an indication that amphetamine-type stimulants use is an increasing issue in terms of reported main substance of concern. Treatment start collections also indicate more impact on physical and mental health for females. Issues for Māori and Pacific peoples warrant further examination, for instance we see alcohol becoming more of an issue in Pacific communities than other substances. Matched pairs show a reduction in substances used between treatment start and treatment end for all substances (Slide 7). What is working? There is still a lot of data to come in and be analysed, the picture may change.

10 Questions, thoughts?