Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST

Abstract

Background There is a need for screening and brief assessment instruments to identify primary care patients with substance use problems. This study’s aim was to examine the performance of a two-step screening and brief assessment instrument, the TAPS Tool, compared to the WHO ASSIST. Methods Two thousand adult primary care patients recruited from five primary care clinics in four Eastern US states completed the TAPS Tool followed by the ASSIST. The ability of the TAPS Tool to identify moderate- and high-risk use scores on the ASSIST was examined using sensitivity and specificity analyses. Results The interviewer and self-administered computer tablet versions of the TAPS Tool generated similar results. The interviewer-administered version (at cut-off of 2), had acceptable sensitivity and specificity for high-risk tobacco (0.90 and 0.77) and alcohol (0.87 and 0.80) use. For illicit drugs, sensitivities were ≥0.82 and specificities ≥0.92. The TAPS (at a cut-off of 1) had good sensitivity and specificity for moderate-risk tobacco use (0.83 and 0.97) and alcohol (0.83 and 0.74). Among illicit drugs, sensitivity was acceptable for moderate-risk of marijuana (0.71), while it was low for all other illicit drugs and non-medical use of prescription medications. Specificities were 0.97 or higher for all illicit drugs and prescription medications. Conclusions The TAPS Tool identified adult primary care patients with high-risk ASSIST scores for all substances as well moderate-risk users of tobacco, alcohol, and marijuana, although it did not perform well in identifying patients with moderate-risk use of other drugs or non-medical use of prescription medications. The advantages of the TAPS Tool over the ASSIST are its more limited number of items and focus solely on substance use in the past 3 months.

The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study

“…TAPS Tool (Tobacco, Alcohol, Prescription Medication and Other Substance Use) ( McNeely et al, 2016b ; Schwartz et al, 2017 )…”

Assessment of Alcohol and Other Substance Use in Patients With Chronic Liver Disease

“…Both the NMASSIST and the TAPS can be administered via self‐report or clinical interview. The TAPS appears to have acceptable sensitivity and specificity for most substances, particularly at high risk levels, although may have low sensitivity for moderate‐risk use of illicit drugs (in addition to cannabis) and non‐medical prescription medications 30 . However, the TAPS is shorter than the NMASSIST, making it a possibly more feasible routine assessment in hepatology practices 30 …”

“…30 However, the TAPS is shorter than the NMASSIST, making it a possibly more feasible routine assessment in hepatology practices. 30…”

Application of Digital Medicine in Addiction

“…When health workers conduct face-to-face interviews with patients, it takes about 5-15 min to complete ASSIST, including complex question skip patterns and score calculations. A digital version of ASSIST [8] and a shortened similar digital screening tool, which is named tobacco, alcohol, prescription medication, and other substance use (TAPS) [9] , are both completed on tablet computers with audio-assisted systems, making it more humanized and rapid to perform screening in health care settings. However, as these tools are primarily used for screening, they are often characterized by high sensitivity for detecting unhealthy substance use but low sensitivity for identifying SUDs, especially for addictive substances that are not commonly seen in primary health care settings.…”