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The Treatment Outcomes Profile

The Treatment Outcomes Profile (TOP) - the tool used for monitoring the effectiveness of substance misuse treatment in England - has been assessed by peer-review as fit for purpose, and is published in Addiction this week.

"The Treatment Outcomes Profile is a reliable and valid 20 item instrument for treatment outcomes monitoring," explains Dr John Marsden, lead researcher for outcomes monitoring in substance misuse, "the drug treatment sector may be assured of the tool's clinical use and value for monitoring treatment and measuring outcomes for the benefit of individuals, communities, and service commissioners and providers."

The TOP was launched in May 2007 and rolled-out to drug treatment providers for service monitoring in October 2007. The National Treatment Agency (NTA) has received around 200,000 completed TOPs via the National Drug Treatment Monitoring System, making the TOP the biggest outcomes database for drug treatment in the world.

Colin Bradbury, NTA Treatment Delivery Manager, adds: "The TOP is proving to be a valid and reliable measure of change. Its applied use will help drive up quality and standards of drug treatment in England."

The tool was validated through a sample of over 1,000 service users, aged 16 – 62, recruited from 63 public treatment organisations in England.

The validation consisted of 38 continuous, scale and period prevalence measures, using a 28-day recall period, across substance misuse, health, crime and social functioning domains, administered as a personal interview by 163 key workers.

The findings were that twenty outcome measures met inter-rater reliability criteria, including:
• days used alcohol, opioids, crack cocaine, cocaine powder, amphetatines, cannabis, and one other named substance
• days injected and period prevalence of direct or indirect needle/syringe sharing
• days committed shop theft and drug selling
• prevalence of vehicle, property fraud/forgery
• assault/violence offences
• subjective rating of physical, psychological health
• quality of life
• days worked and attended education
• prevalence of acute housing problems and risk of eviction

There was satisfactory validity assessment and the change sensitivity of these items was evidenced by effective size, the smallest detectable difference and by reliable change index.

The TOP clinical tool contains an additional 10 items to assist individual treatment planning and review.

Article originally published on 09/08/2008 by DryOutNow.com, the alcohol specific website for Addiction Advisor

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