Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients

Nordeck, Courtney D.; Gryczynski, Jan; O’Grady, Kevin E.; Polak, Kathryn; Svikis, Dace; McNeely, Jennifer; Wu, Li‐Tzy; Schwartz, Robert P.

doi:10.1016/j.drugalcdep.2020.107939

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…Furthermore, although recall for cannabis is best for the past 30 days, the test–retest reliability of 6‐ and 12‐month recall periods are also excellent 46,48 . A number of studies have validated self‐reports of substance use and show high concordance between self‐reports of cannabis use as compared with toxicology results 49,50 . Together this, along with data that shows self‐reports of substance use have high concordance with toxicology results suggests that although there may be bias resulting from the way in which cannabis use is assessed, the EHR assessment favors those who are recent and more regular cannabis users.…”

Section: Discussionmentioning

confidence: 99%

Cannabis use, comorbidities, and prescription medication use among older adults in a large healthcare system in Los Angeles, CA 2019–2020

Javanbakht

Takada

Akabike

et al. 2022

J American Geriatrics Society

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Objective To describe the reported prevalence of cannabis use and co‐use with prescription medications among older adult patients attending primary care (PC) clinics in Los Angeles, CA. Methods We used electronic health record (EHR) data from sixty PC clinics part of a university‐based, urban healthcare system. Patients' ≥50 years of age with an annual physical examination between July 2019 and May 2020 were eligible for inclusion (n = 42,555). Cannabis use was assessed by clinic staff at the time of the visit and recorded in the EHR. We also used EHR data on clinical characteristics including current prescriptions and comorbidities. Results The median age was 63 years (range: 50–101) and 56% were female. Recent cannabis use was reported by 7.6%, which was higher than tobacco use (4.0%; p < 0.01). Prevalence of cannabis use was higher among patients prescribed psychotropic medications. For instance, 10.9% of patients prescribed benzodiazepines reported cannabis use as compared with 7.3% among patients without a prescription for benzodiazepines (p < 0.01). Patients with neurologic/musculoskeletal medications such as antiepileptics also had a higher prevalence of cannabis use when compared with those without these prescriptions (13.6% vs. 7.6% respectively; p < 0.01) as did those who were prescribed muscle relaxants (10.3% vs. 7.5% respectively; p < 0.01). After adjusting for age, sex, race/ethnicity, and comorbidities those prescribed medications for psychiatric (adjusted OR = 1.5; 95% CI 1.4–1.7), respiratory (adjusted OR = 1.2; 95% CI 1.1–1.3), or neurologic conditions (adjusted OR = 1.4; 95% CI 1.2–1.5) had increased odds of cannabis use compared with those not prescribed these medications. Discussion The prevalence of cannabis use among older adults attending PC clinics in a university‐based healthcare system was higher among those prescribed medications, which may interact with cannabis. These findings suggest that key groups of older patients who may benefit from routine PC screening for cannabis use and brief advice.

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Section: Discussionmentioning

confidence: 99%

Cannabis use, comorbidities, and prescription medication use among older adults in a large healthcare system in Los Angeles, CA 2019–2020

Javanbakht

Takada

Akabike

et al. 2022

J American Geriatrics Society

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“…In addition, high discordance between individuals with a positive oral fluid test and negative TLFB report could be due to patient fears over disclosure, 10 which may be present even when patients are assured of confidentiality. The discordance was largely driven by nonmedical use of prescription opioids (n = 64) as compared with heroin use (n = 14), a finding supported in a related study that used a smaller TLFB window 10 . This may suggest that some individuals misunderstood the question about nonmedical use, or individuals who engage in nonmedical use of prescription opioids may be particularly attentive to concerns of stigma, as has been found for patients with chronic pain 11 .…”

Section: Discussionmentioning

confidence: 99%

“…The limited window of oral fluid testing and small sample of persons who use opioids in this patient population should be considered. In addition, high discordance between individuals with a positive oral fluid test and negative TLFB report could be due to patient fears over disclosure, 10 which may be present even when patients are assured of confidentiality. The discordance was largely driven by nonmedical use of prescription opioids (n = 64) as compared with heroin use (n = 14), a finding supported in a related study that used a smaller TLFB window 10 .…”

Section: Discussionmentioning

confidence: 99%

A Brief Screening and Assessment Tool for Opioid Use in Adults: Results from a Validation Study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool

Bunting

Schwartz²,

Wu³

et al. 2023

J Addict Med

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Objectives: This secondary analysis evaluated opioid-specific validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) tool for screening in primary care. Methods: This study is a secondary data analysis of the TAPS validation study. Performance of the TAPS tool for screening for unhealthy opioid use (with a score of 1+ for heroin and/or prescription opioids representing a positive screen) was evaluated. Discriminative ability was examined in comparison with reference standard measures across the spectrum of unhealthy opioid use: timeline follow-back with and without oral fluid testing identifying past-month use and the modified Composite International Diagnostic Interview for past-year problem use, opioid use disorder (OUD), and moderate-severe OUD. Results: In a sample of 2000 primary care patients, 114 screened positive for opioids on the TAPS tool. With a TAPS cutoff equal to 1+, the TAPS accurately identified past-month use, problem use, any OUD, and moderate-severe OUD (sensitivities = 68%-85%, specificities = 97%-98%, area under the curve = 0.80-0.91). When past-month use was expanded to include timeline follow-back with oral fluid testing,

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“…Psychometric properties of the TLFB have been examined in a range of populations including the following: men and women (Sobell & Sobell, 1992), individuals with varying levels of alcohol use severity (Sobell & Sobell, 1992), individuals from diverse racial and ethnic backgrounds in the United States (Dillon et al, 2005;W. Liu et al, 2019;Nordeck et al, 2020), cross-culturally (Sobell et al, 2001), in a variety of settings (W. Liu et al, 2019;Nordeck et al, 2020;Sobell & Sobell, 1992), and in Spanish (Sobell et al, 2001). To our knowledge, the validity of the TLFB has not been assessed explicitly in AI/AN populations.…”

Section: Timeline Followback Interviewmentioning

confidence: 99%

“…Liu et al, 2019; Nordeck et al, 2020), cross-culturally (Sobell et al, 2001), in a variety of settings (W. Liu et al, 2019; Nordeck et al, 2020; Sobell & Sobell, 1992), and in Spanish (Sobell et al, 2001). To our knowledge, the validity of the TLFB has not been assessed explicitly in AI/AN populations.…”

Section: Summary Of Review Findingsmentioning

confidence: 99%

A clinical science guide for reviewing the cross-cultural rigor of assessments in an alcohol training clinic.

Hernandez-Vallant¹,

Votaw²,

Herron³

et al. 2024

Psychological Services

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A standard component of service delivery in alcohol treatment clinics is evidence-based assessment (EBA). Although EBA is essential for selecting appropriate treatment modalities for alcohol use and associated problems, there are limitations in existing EBAs concerning evidence of cultural equivalence and utility among individuals seeking alcohol treatment. However, training in EBA, addictions, and clinical applications with diverse populations all are gaps in clinical training in doctoral programs in clinical psychology. The present work used the clinical science model to review the psychometric properties, cross-cultural utility, and measurement invariance of measures in an assessment battery used in an alcohol treatment training clinic. This article describes the results of that review, recommendations for retaining or replacing common assessment measures used in alcohol treatment clinics, and recommendations for alcohol treatment clinics interested in engaging in similar processes. Findings suggested that more research is needed to evaluate the psychometric properties of EBAs utilized in an alcohol treatment assessment battery, particularly among American Indian and Alaska Native people, and to test measurement invariance across race/ethnicity and other identity groups in alcohol treatment-seeking populations. Overall, routine reviews of cultural relevance are needed in clinical settings to stay current with the emerging literature.

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Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients

Cited by 9 publications

References 19 publications

Cannabis use, comorbidities, and prescription medication use among older adults in a large healthcare system in Los Angeles, CA 2019–2020

Cannabis use, comorbidities, and prescription medication use among older adults in a large healthcare system in Los Angeles, CA 2019–2020

A Brief Screening and Assessment Tool for Opioid Use in Adults: Results from a Validation Study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool

A clinical science guide for reviewing the cross-cultural rigor of assessments in an alcohol training clinic.

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