Studies of the consequence of treatment for alcohol-related question s provide information on treatment efficacy and allow different treatments to be compared.

Studies of the consequence of treatment for alcohol-related question s provide information on treatment efficacy and allow different treatments to be compared. This information permits researchers to improve treatments and render certains that clinicians can provide the best available treatment to their patients. This article discusses the ne for standardized measures of treatment result the development of standardized measures by means of the California Society of Addiction Medicine, and the prototypes of outcome studies that can be performed.

Although researchers have begun to report data obtained from monitoring treatment issue there has been a lack of standardization of issue measures. The measurement of consequence often has been so different from research to study that it was impossible to compare the studies' results: no meta-analysis(1) was possible. For example, four articles forward the treatment of cocaine staff included outcome assessments. Although all studies reported upon abstinence, stated when followup occurr and described the population followed up the measures used were too different to allow the terminates of the studies to be compared:

* Abstinence, defined as les than once-a-month

use of cocaine; followup occurred

at 6 to 11 months; the

description of the number of patients

assessed was inadequate.

* Total abstinence, defined as abstaining

from all chemicals; followup occurred

at 1 to 3 years following

treatment; 77 percent of patients were

assessed at the initial followup point,

unless the article reported results no other than for

a subsample of patients.

* popular abstinence, defined only in

names of use, no time was specified;

followup occurr at 7 to 19 months;

100 percent of patients were assessed.

* Total abstinence, defined as no use of

cocaine, and passing from hand to hand abstinence, defined

as no use of cocaine for 6

month prior to followup; followup

occurr at 12 months; 72 percent of

patients were assessed.

It is this lack of standardization and definition that has hampered the joining of research and clinical efforts.

Practicing clinicians do not believe that standardizing measures for issue monitoring is an academic problem: clinicians have an ethical obligation to assure themselves and their patients that the treatment provided is the best available for their patients' disease. Treatment issue research should play a significant part both in advancing knowledge of treatment efficacy and in informing clinicians that the care they provide is appropriate, efficient, and effective. Moreover, third-party payers demand that patients be admitted to appropriate of the same heights of care, and research upon treatment outcome is needed to make sure that this is done.

Dr Longabaugh (see pp 189-200) has propos that a standardized core of consequence measurements be utilized in treatment issue research, and he has followed real closely the outcome measures commended by the Treatment Outcome Committee of the California Society of Addiction Medicine. The list below prioritizes the measures the society believes should be included in any treatment result study:

1. Substance Use

* Report the status of use of the primary

remedy or drugs of dependence

for which the patient entered

treatment

* Report the status of use of all

addictive chemicals

* Report any use, since the start of

treatment, of medications prescribed

for their psychotropic action

2 Readmission to Treatment for Chemical colony Due to Reuse or Threatened Reuse

3 Health Status

* Health service utilization

* mortality

* number of hospitalizations since

the start of treatment

* medical or dental outpatient visits

its since the start of treatment

* Confirmation of health status (recommended)

using appropriate biochemical

markers associated with

the patient's illness and standardized

interviews, psychological

trials and rating scales

4 service Functioning Status

* office status at followup

* Number (or percent) of days

worked compared to total days eligible

to work

5 Legal Problems

* adventures of driving while under

the influence of alcohol or drugs

* Arrests

6 Relationships with clog Family and

Significant Others (confirmation from

family members and significant others

is recommended)

* Marital status at followup (includes

same-sex and opposite-sex partners)

* Relationship status assessments

may include

* satisfaction with relationships at

followup

* quality of family interactions at

followup

* Custody status of children, if patient

is parent of minors

Priorities were assigned to the issue measures to guide programs when choosing which measures to assess. This make secures that the most important measures will be assessed if the splendor of outcome monitoring limits what can be studied.

part of the California Society of Addiction Medicine

The California Society of Addiction Medicine formed the Treatment issue Committee to address difficulties clinicians battleed when they attempted to obtain information upon treatment research studies. Initially, the committee studied patient characteristics, or prognostic factors, that can affect the result of the patients' treatment. so factors include age, employment status, and whether the patient was abusing single or more drugs. The committee capered that an understanding of the relationship between prognostic factors and treatment result would allow patients to be assigned to appropriate treatments. It eventually became clear that before prognostic factors could be used to assign patients to treatments, the question, Prognosis for what kind of outcome? needinessed to be answered. The committee therefore shifted its emphasis to identifying standard constituent principles that should be included in studies of treatment outcome