COMPREHENSIVE REVIEW A systematic review of substance misuse assessment packages JENNIFER SWEETMAN 1 , DUNCAN RAISTRICK 1 , NOREEN D. MDEGE 2 & HELEN CROSBY 1 1 Leeds Addiction Unit, Leeds, UK, and 2 Department of Health Sciences, University of York, York, UK Abstract Issues. Health-care systems globally are moving away from process measures of performance to payments for outcomes achieved. It follows that there is a need for a selection of proven quality tools that are suitable for undertaking comprehensive assessments and outcomes assessments.This review aimed to identify and evaluate existing comprehensive assessment packages. The work is part of a national program in the UK, Collaborations in Leadership of Applied Health Research and Care. Approach. Systematic searches were carried out across major databases to identify instruments designed to assess substance misuse. For those instruments identified, searches were carried out using the Cochrane Library, Embase, Ovid MEDLINE ® and PsychINFO to identify articles reporting psychometric data. Key Findings. From 595 instruments, six met the inclusion criteria: Addiction Severity Index; Chemical Use, Abuse and Dependence Scale; Form 90; Maudsley Addiction Profile; Measurements in the Addictions for Triage and Evaluation; and Substance Abuse Outcomes Module. The most common reasons for exclusion were that instruments were: (i) designed for a specific substance (239); (ii) not designed for use in addiction settings (136); (iii) not providing comprehensive assessment (89); and (iv) not suitable as an outcome measure (20). Implications. The six packages are very different and suited to different uses. No package had adequate evaluation of their properties and so the emphasis should be on refining a small number of tools with very general application rather than creating new ones. An alternative to using ‘off-the-shelf’ packages is to create bespoke packages from well-validated, single-construct scales. [Sweetman J, Raistrick D, Mdege ND, Crosby H. A systematic review of substance misuse assessment packages. Drug Alcohol Rev 2013;32:347–355] Key words: alcohol, assessment, dependence, illicit drug, substance misuse. Introduction This review was undertaken as part of a program of research, Collaborations in Leadership of Applied Health Research and Care (CLAHRC), and accompa- nies a review of screening tools and interventions. Nine CLAHRC programs were established to answer specific research questions for the National Health Service in the UK, and all the CLAHRCs are a collaboration between academics, clinicians and commissioners. One CLAHRC has an addictions program within which this review was a prerequisite of a workstream to develop outcomes assessments. Assessment is fundamental to the work of health-care professionals [1–4]. For addiction services, assessment provides an opportunity for practitioners to understand service user needs and develop appropriate treatment plans [5]. Addiction practitioners and service users can also use the process to agree treatment goals, monitor the progress of treatment and review treatment effec- tiveness through measuring outcomes [6]. Assessment may vary depending on the setting (e.g. primary care, general hospital wards and mental health services) or on the readiness for treatment. A degree of standardi- sation of assessment, coupled with standardised outcome reporting, would enable the comparison of services locally, nationally and internationally [7]. In some health-care systems, assessment is linked to treat- ment pathways and associated funding tariffs [8]. Inconsistent or inappropriate assessment can have a number of negative impacts. Underestimating the level of treatment need may lead to service users not receiv- Jennifer Sweetman MRes, Research Practitioner, Duncan Raistrick MBChB, MPhil, FRCPsych, Consultant Addiction Psychiatrist, Noreen D. Mdege, MPH, Research Fellow, Helen Crosby MSc, Researcher. Correspondence to Mrs Jennifer Sweetman, Leeds Addiction Unit, 19 Springfield Mount, Leeds, LS2 9NG, UK.Tel: +44 (0) 113 295 1300; Fax: +44 (0) 113 305 0253; E-mail: j.sweetman@nhs.net Received 6 August 2012; accepted for publication 20 February 2013. REVIEW Drug and Alcohol Review (July 2013), 32, 347–355 DOI: 10.1111/dar.12039 © 2013 Australasian Professional Society on Alcohol and other Drugs