Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Abstract

Introduction The need for innovative approaches to address the opioid epidemic in the United States is widely recognized. Many challenges exist to addressing this epidemic, including the obstacles outpatient substance use treatment practices face in implementing measurement-based care (MBC), quality measurement systems, and evidence-based treatments. Also, there are insufficient opportunities for clinicians in these settings to participate in research, resulting in diminished translation of research findings into community-based practice. To address these challenges, the Addiction Medicine Practice-Based Research Network (AMNet) was developed to facilitate the uptake of MBC in outpatient practices via implementation of patient-reported assessments and quality of care performance measures to improve patient outcomes. This network will offer clinicians in outpatient settings (not incuding opioid treatment programs [OTPs]) the opportunity to participate in future substance use disorder treatment research studies. Methods A key step in the development of AMNet was the selection of substance use-specific assessment tools and quality of care performance measures for incorporation into the American Psychiatric Association’s mental health patient registry, PsychPRO. A scoping review and multi-step consensus-based process were used to identify, review and select candidate assessment tools and quality of care performance measures for opioid use disorders (OUD) and substance use disorders (SUD). Results Following a consensus-based methodology, 12 standardized assessment tools and 3 quality of care performance measures for OUD and SUD were selected to help facilitate the implementation of MBC and quality improvement for AMNet participants. These tools were further categorized as core and optional. Conclusion By offering a collection of carefully vetted assessment tools and quality measures through PsychPRO, AMNet will help participating clinicians with the systematic uptake of MBC and delivery of evidence-based treatment for patients with SUD. Also, AMNet will act as a centralized repository of data collected from patients and clinicians in non-OTP outpatient addiction medicine practices and serve as a platform for opioid treatment research.

Towards shortening the Brief Addiction Monitor-Revised (BAM-R)

“…: Frequency of use is a standard metric in substance use treatment, and we retained items assessing frequency of heavy alcohol use and drug use. As noted by Clarke et al. (2021) , the Craving (8) item is actionable for MBC and could facilitate conversations to increase therapeutic alliance and motivation.…”

“…MBC is operationalized as “enhanced precision and consistency in disease assessment, tracking, and treatment to achieve optimal outcomes” ( Harding et al., 2011 , p. 1137), which includes repeated assessments of patient outcomes to guide shared decision-making between patients and clinicians (see Fortney et al., 2017 ; Goodman et al., 2013 ; Trivedi and Daly, 2007 ). The Addiction Medicine Practice-Based Research Network listed the BAM as a recommended assessment tool for implementation of MBC for opioid use disorders (OUD) and SUD ( Clarke et al., 2021 ). The Kennedy Forum lists the BAM in its recommended core set of SUD outcome measures ( Wrenn et al., 2017 ).…”

Using Quality Measures and Measurement-Based Care to Improve Behavioral Health Care for Veterans and Service Members

“…The highest volume of evidence for the efficacy of MBC is in patients with depression and anxiety disorders (Peterson, Anderson, and Bourne, 2018). Although MBC is being implemented in clinics that serve patients with PTSD and SUD, the evidence for its efficacy has not been as rigorously established; no randomized controlled trials of MBC in PTSD or SUD appear to have been completed (Clarke et al, 2021;Hallgren, 2022;Hallgren et al, 2022;Liebmann, Resnick, and Stacy, 2022;Singh et al, 2022).…”

Tools to implement measurement-based care (MBC) in the treatment of opioid use disorder (OUD): toward a consensus

“…An effectiveness-implementation trial, the measurement-based care to opioid treatment programs project (MBC2OTP), has been launched to inform this important question in opioid treatment programs [ 17 ]. The Addiction Medicine Practice-Based Research Network (AMNet) employed a multi-step consensus-based approach for selecting 12 standardized assessment tools and 3 quality of care performance measures for OUD and SUD to facilitate MBC and quality improvement in non-opioid treatment programs [ 18 ]. In general, that paper’s objective to support a quality registry including common data elements (CDE) is distinct from those in our paper, as described below.…”