title: Establishing the feasibility of measuring performance in use of addiction pharmacotherapy.
abstract: This paper presents the rationale and feasibility of standardized performance measures for use of pharmacotherapy in the treatment of substance use disorders (SUD), an evidence-based practice and critical component of treatment that is often underused. These measures have been developed and specified by the Washington Circle, to measure treatment of alcohol and opioid dependence with FDA-approved prescription medications for use in office-based general health and addiction specialty care. Measures were pilot tested in private health plans, the Veterans Health Administration (VHA), and Medicaid. Testing revealed that use of standardized measures using administrative data for overall use and initiation of SUD pharmacotherapy is feasible and practical. Prevalence of diagnoses and use of pharmacotherapy vary widely across health systems. Pharmacotherapy is generally used in a limited portion of those for whom it might be indicated. An important methodological point is that results are sensitive to specifications, so that standardization is critical to measuring performance across systems.
authors.affiliation: Schneider Institutes for Health Policy, Brandeis University, Waltham, MA 02454, USA. cthomas@brandeis.edu
authors.forename: Cindy Parks
authors.initials: CP
authors.lastname: Thomas
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Garnick
authors.forename: Constance M
authors.initials: CM
authors.lastname: Horgan
authors.forename: Kay
authors.initials: K
authors.lastname: Miller
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy*; D016208:Databases, Factual; D017277:Drug Approval; D055317:Evidence-Based Practice; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D019966:Substance-Related Disorders / Q000188:drug therapy*; D014481:United States; D014486:United States Food and Drug Administration; D055815:Young Adult