ORIGINAL RESEARCH Measuring recovery in opioid use disorder: clinical utility and psychometric properties of the Treatment Effectiveness Assessment This article was published in the following Dove Press journal: Substance Abuse and Rehabilitation Walter Ling 1 Vijay R Nadipelli 2 Caitlyn T Solem 3 David Farabee 1, 4 Naoko A Ronquest 2 Brian Perrochet 1, 5 Susan M Learned 6 Chinmay G Deshpande 3 Christian Heidbreder 7 1 UCLA Department of Family Medicine, Center for Behavioral and Addiction Medicine, Los Angeles, CA, USA; 2 Global Health Economics and Outcomes Research, Indivior Inc, Richmond, VA, USA; 3 Patient-centered outcomes Center of Excellence, Pharmerit International, Bethesda, ML, USA; 4 Department of Population Health, School of Medicine,, New York, NY, USA; 5 Marron Institute of Urban Management, Marron Institute, New York University, New York, NY, USA; 6 Global Medicines Development, Indivior Inc, Richmond, VA, USA; 7 Global Research and Development, Indivior Inc, Richmond, VA, USA Purpose: The Treatment Effectiveness Assessment (TEA) is a patient-centered instrument for evaluating treatment progress and recovery from substance use disorders, including opioid use disorder (OUD). We assessed the TEA ’ s reliability and validity and determined minimal clinically important differences (MIDs) in participants with moderate to severe OUD. Patients and methods: The TEA measures change in four single-item domains (substance use, health, lifestyle, community involvement) from treatment initiation across the duration of a treatment program. Self-reported responses range from 1 (“none or not much”) to 10 (“much better”) with items summed to a total score ranging from 4–40. We assessed floor and ceiling effects, internal consistency, test-retest reliability, known-groups validity (ANOVA stratified by current health status [36-Item Short Form Health Survey item 1]), convergent/divergent validity, and MIDs using data from a phase 3, open-label clinical trial of buprenorphine extended-release monthly injection for subcutaneous use (BUP-XR). Participants with OUD completed the TEA at screening and before monthly injections for up to 12 months. Results: Among 410 participants (mean age 38 years; 64% male), the mean baseline (pre- injection 1) TEA total score was 25.4 (SD 9.7), with <10% of participants at the measure floor and 10%–20% at the ceiling across domains. Internal consistency was high (Cronbach’ s α=0.90), with marginal test-retest reliability (intraclass correlation coefficient =0.69). Mean TEA total score consistently increased from baseline (n=410; mean 25.4 [SD 9.7]) to end of study (n=337; 35.0 [6.7]) and differentiated between current health status groups (P<0.001); it was weakly correlated with other measures of health-related quality of life/severity. MIDs ranged from 5–8 for the TEA total score across anchor- and distribution-based approaches. Conclusion: The TEA exhibited acceptable reliability and validity in a cohort of partici- pants with moderate to severe OUD treated with BUP-XR. Given its brevity and psycho- metric properties, the TEA is a promising tool for use in clinical practice and research. Keywords: Treatment Effectiveness Assessment, TEA, opioid use disorder, patient-reported outcomes, addiction, psychometrics Introduction Most studies evaluating the treatment of substance use disorders (SUDs), including opioid use disorder (OUD), focus on measuring retention and abstinence, paying little attention to recovery. Retention and abstinence alone may not adequately describe a person’ s recovery journey toward regaining and maintaining a mean- ingful and useful life. 1,2 Tools clinicians can use to easily measure gains in life Correspondence: Walter Ling UCLA Department of Family Medicine, Center for Behavioral & Addiction Medicine, 16556 Park Lane Circle, Los Angeles, CA 90049, USA Tel +1 310 993 8111; +1 310 476 6940 Email lwalter@ucla.edu Substance Abuse and Rehabilitation Dovepress open access to scientific and medical research Open Access Full Text Article submit your manuscript | www.dovepress.com Substance Abuse and Rehabilitation 2019:10 13–21 13 DovePress © 2019 Ling et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). http://doi.org/10.2147/SAR.S198361 Substance Abuse and Rehabilitation downloaded from https://www.dovepress.com/ by 3.92.57.205 on 20-May-2020 For personal use only. 1 / 1