Transcript Exit from Treatment Indicator

GREEK REITOX FOCAL POINT
3-4 OCTOBER 2002
Lisbon
Pompidou Group Project: Development
and Testing of Exit from Treatment Form
– ETI* for Clients in Drug Abuse
Treatment
*TDF (Treatment Discharge Form)  ETI (Exit
from Treatment Indicator)
Main objectives:
1st phase:

To develop and test a standard form
for collecting core data on clients at the exit
from treatment (completed, premature
discharge or drop out)

To register core information for followup

Test the feasibility of linking data at
entry (TDI) with those at the exit (ETI)
through anonymous identifiers
Main objectives:
2nd phase:

To test the relevance of characteristics at
entry to those at exit in order to identify
variables that might have an impact on the mode
of discharge and the situation of the client upon
it

To test the feasibility of developing a
Treatment Retention Registration System
(TRRS)
PARTICIPANTS: 15 cities from 6 countries
• France (Brest, Metz, Marseille, Nice, Paris, St
Etienne)
• Greece (Athens, Thessaloniki)
• Italy (Rome)
• Russia (Moscow, St Petersburg)
• Slovenia (Murska Sobota)
• UK (Salford, Manchester)
3 Questionnaires:
 ETI Core Item List: information for the client
 Treatment Unit’s/Programme’s Director: information for the
programme
 Key worker’s questionnaire: for evaluation of the ETI
12 ITEMS:
 City
 Treatment unit name
 Client identifier
 Type of treatment unit (substitution – drug free, inpatient –
outpatient)
 Date of intake
 Date of discharge/last contact with client
 Type of contact with this unit (old – new client)
 Type of admission (regular – priority list, judicial etc)
 Special population subgroup (adolescent, probation, dual
diagnosis)
 Type of treatment the client followed (detoxification,
substitution, drug-free, advice etc)
 Mode of discharge (completed, drop out, discharge,
referral, deceased, change of residence, imprisoned)
 Situation of client upon discharge (drug use, physical –
psychological health, judiciary, social relationships,
employment, housing)
Programs participating:
2 substitution programs in Athens (outpatient)
1 drug – free program in Athens (outpatient)
1 drug – free program in Thessaloniki (inpatient)
Forms collected:
81 Discharge Forms: 62 from substitution
19 from drug-free
Results
 40,8% of data already exists (the highest among
countries)
 missing values per item varied from 1,2% to 9,8%
 the highest: special population subgroup
Efficiency of identifiers (TDI – ETI):

74 out of 81 (91,4%) clients matched

mean time between intake and discharge: 13
months
Type of contact:


71 (87,7%) new clients
6 (7,4%) old clients
Type of admission:


68 (83,9%) regular waiting list
12 (14,8%) priority
Special population subgroup:



64 (79%) no special subgroup
8 (9,9%) dual diagnosis
1 (1,2%) probation or parole
Type of treatment (more than one choice):




51 (63%) advice/counseling
39 (48,1%) maintenance
18 (22,2%) medicament free therapy
11 (13,5%) detoxification
Mode of discharge:
 30 (37%) premature discharge
 22 (27,2%) treatment completed
 8 (9,9%) referral
Drug situation upon discharge:



29 (35,8%) drug free
27 (33,3%) worsened
15 (18,5%) improved
Health situation:



34 (42%) improved
32 (39,5%) stable
13 (165) worsened
Judiciary situation:



52 (64,2%) no judicial involvement
18 (22,2%) awaiting trial
6 (7,4%) missing
Psychological situation:



29 (35,8%) improved
28 (34,6%) stable
21 (25,9%) worsened
Social relationships:



39 (48,1%) stable
26 (32,1%) improved
15 (18,5%) worsened
Employment situation:



39 (48,1%) unemployed
25 (30,9%) part time
14 (17,3%) full time
Housing/living conditions:



49 (60,5%) with family/relatives
19 (23,5%) own apartment
5 (6,2%) sharing apartment
Results from 66 Evaluation Forms:
 quick and very easy to complete
 item 10 and 12 most difficult
Further comments:
 the client’s disposition to re-approach the Unit
 the client’s marital status
 add categories to special population subgroup
STRENGTHS

promotes thinking about the possible uses of
treatment discharge data

comparable results for further comparisons,
treatment quality evaluation and rehabilitation prognosis

have proved the feasibility of the instrument in
out-patient and in-patient settings

offers the basis for follow-up after exit from
treatment
LIMITS TO EVALUATING

short duration of the development phase of the
instrument

the limited number of participating countries did
not permit a broad enough range of opinion to be
canvassed

the qualitative character of some items
FURTHER CONSIDERATIONS
 incorporate feedback from the agents
 great obstacles in evaluation of treatment:
reconsideration or readjustment of targets
The End