Quick Substance-Abuse Screening Tool Demonstrates Effectiveness

September 30, 2016 | Strategic Insights for Ambulatory Care

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​A flexible, four-item substance-abuse screening tool that can easily be integrated into clinical workflows was found to be effective, according a study published September 6, 2016, in the Annals of Internal Medicine. The Tobacco, Alcohol, Prescription Medication, and other Substance use (TAPS) tool was able to identify clinically relevant substance abuse in a diverse study population that included 2,000 patients from suburban and urban clinics in Maryland, New York, Virginia, and North Carolina. The interviewer- and self-administered versions of the tool were validated by comparison with the modified World Mental Health Composite International Diagnostic Interview, which the authors said is the "gold standard reference." The first part of the tool (TAPS-1) asks users how often they have consumed alcohol (above guideline-recommended limits: five or more drinks per day for men, four or more drinks per day for women), used tobacco, used illegal drugs, or used prescription medications for nonmedical purposes over the previous 12 months. Typically, any response other than "never" to this question is considered a positive result and the user would then complete a corresponding TAPS-2 questionnaire, in order to obtain a more accurate picture of the person's level of risk. In this study, however, all participants completed TAPS-2 regardless of their answers to TAPS-1. TAPS had a sensitivity of 0.93 and a specificity of 0.87 for tobacco abuse.

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