Comparative Effectiveness of Clinical Decision-Making Required by Public Health Systems

Assisting providers implementing addiction medicine criteria in the assessment of addiction treatment outcomes

Assessing treatment outcomes is vital for providers in order to maximize both treatment effectiveness and cost-effectiveness of treatment. To compare the effectiveness of approaches that public substance use disorder systems are using to refer patients to particular addiction treatment settings, RTI assisted providers following the American Society of Addiction Medicine (ASAM) criteria, which were developed to provide a systematic, evidence-based, and transparent approach to addiction treatment matching. With several counties in California requiring that addiction providers use the ASAM criteria as a key component of patient assessment and treatment recommendations, RTI is leading a study to determine whether this health system change leads to better addiction treatment outcomes. RTI is also examining whether using ASAM criteria results in better communication with patients about treatment outcomes. RTI compared outcomes – including wait-time for treatment entry, length of stay in treatment, successful treatment completion, patient satisfaction with placement decisions, patient reported engagement, motivation for change, therapeutic alliance, use of substance use disorder (SUD) residential settings, and SUD-related hospitalizations – across three SUD levels of care decision-making approaches. As a result, RTI will improve knowledge of the comparative effectiveness of decision-making processes for determining the level of care for treatment of substance use disorders.