PDF(Pubmed)
Abstract：
BACKGROUND: Measurement-based care in behavioral health uses patient-reported outcome measures (PROMs) to screen for mental health symptoms and substance use and to assess symptom change over time. While PROMs are increasingly being integrated into electronic health record systems and administered electronically, paper-based PROMs continue to be used. It is unclear if it is feasible to administer a PROM on paper when the PROM was initially developed for electronic administration.
OBJECTIVE: This study aimed to examine the feasibility of patient self-administration of a 2-part substance use screener-the Tobacco, Alcohol, Prescription medications, and other Substances (TAPS)-on paper. This screener was originally developed for electronic administration. It begins with a limited number of questions and branches to either skip or reflex to additional questions based on an individual\'s responses. In this study, the TAPS was adapted for paper use due to barriers to electronic administration within an urgent care behavioral health clinic at an urban health safety net hospital.
METHODS: From August 2021 to March 2022, research staff collected deidentified paper TAPS responses and tracked TAPS completion rates and adherence to questionnaire instructions. A retrospective chart review was subsequently conducted to obtain demographic information for the patients who presented to the clinic between August 2021 and March 2022. Since the initial information collected from TAPS responses was deidentified, demographic information was not linked to the individual TAPS screeners that were tracked by research staff.
RESULTS: A total of 507 new patients were seen in the clinic with a mean age of 38.7 (SD 16.6) years. In all, 258 (50.9%) patients were male. They were predominantly Black (n=212, 41.8%), White (n=152, 30%), and non-Hispanic or non-Latino (n=403, 79.5%). Most of the patients were publicly insured (n=411, 81.1%). Among these 507 patients, 313 (61.7%) completed the TAPS screener. Of these 313 patients, 76 (24.3%) adhered to the instructions and 237 (75.7%) did not follow the instructions correctly. Of the 237 respondents who did not follow the instructions correctly, 166 (70%) answered more questions and 71 (30%) answered fewer questions than required in TAPS part 2. Among the 237 patients who did not adhere to questionnaire instructions, 44 (18.6%) responded in a way that contradicted their response in part 1 of the screener and ultimately affected their overall TAPS score.
CONCLUSIONS: It was challenging for patients to adhere to questionnaire instructions when completing a substance use screener on paper that was originally developed for electronic use. When selecting PROMs for measurement-based care, it is important to consider the structure of the questionnaire and how the PROM will be administered to determine if additional support for PROM self-administration needs to be implemented.
OBJECTIVE: This study aimed to examine the feasibility of patient self-administration of a 2-part substance use screener-the Tobacco, Alcohol, Prescription medications, and other Substances (TAPS)-on paper. This screener was originally developed for electronic administration. It begins with a limited number of questions and branches to either skip or reflex to additional questions based on an individual\'s responses. In this study, the TAPS was adapted for paper use due to barriers to electronic administration within an urgent care behavioral health clinic at an urban health safety net hospital.
METHODS: From August 2021 to March 2022, research staff collected deidentified paper TAPS responses and tracked TAPS completion rates and adherence to questionnaire instructions. A retrospective chart review was subsequently conducted to obtain demographic information for the patients who presented to the clinic between August 2021 and March 2022. Since the initial information collected from TAPS responses was deidentified, demographic information was not linked to the individual TAPS screeners that were tracked by research staff.
RESULTS: A total of 507 new patients were seen in the clinic with a mean age of 38.7 (SD 16.6) years. In all, 258 (50.9%) patients were male. They were predominantly Black (n=212, 41.8%), White (n=152, 30%), and non-Hispanic or non-Latino (n=403, 79.5%). Most of the patients were publicly insured (n=411, 81.1%). Among these 507 patients, 313 (61.7%) completed the TAPS screener. Of these 313 patients, 76 (24.3%) adhered to the instructions and 237 (75.7%) did not follow the instructions correctly. Of the 237 respondents who did not follow the instructions correctly, 166 (70%) answered more questions and 71 (30%) answered fewer questions than required in TAPS part 2. Among the 237 patients who did not adhere to questionnaire instructions, 44 (18.6%) responded in a way that contradicted their response in part 1 of the screener and ultimately affected their overall TAPS score.
CONCLUSIONS: It was challenging for patients to adhere to questionnaire instructions when completing a substance use screener on paper that was originally developed for electronic use. When selecting PROMs for measurement-based care, it is important to consider the structure of the questionnaire and how the PROM will be administered to determine if additional support for PROM self-administration needs to be implemented.
摘要：
背景：行为健康中基于测量的护理使用患者报告的结果测量（PROMs）来筛查心理健康症状和药物使用，并评估症状随时间的变化。虽然PROM越来越多地集成到电子健康记录系统中并以电子方式管理，纸质PROM继续使用。尚不清楚当PROM最初开发用于电子管理时，在纸上管理PROM是否可行。
目的：本研究旨在检查患者自行服用2部分物质使用筛查剂的可行性-烟草，酒精,处方药,和其他物质（TAPS）-在纸上。该筛选器最初是为电子管理而开发的。它从有限数量的问题开始，并根据个人的回答跳过或反射到其他问题。在这项研究中,由于城市健康安全网医院的紧急护理行为健康诊所的电子管理障碍,TAPS适用于纸质使用.
方法：从2021年8月到2022年3月，研究人员收集了未识别的TAPS论文回答，并跟踪TAPS完成率和对问卷说明的依从性。随后进行了回顾性图表审查，以获取2021年8月至2022年3月期间到诊所就诊的患者的人口统计学信息。由于从TAPS响应中收集的初始信息被取消识别，人口统计信息与研究人员跟踪的单个TAPS筛查员没有关联.
结果：共有507例新患者在临床就诊，平均年龄为38.7（SD16.6）岁。总之,258例（50.9%）患者为男性。他们主要是黑人（n=212，41.8%），白色(n=152,30%),非西班牙裔或非拉丁裔（n=403，79.5%）。大多数患者是公共保险（n=411，81.1％）。在这507名患者中，313（61.7％）完成了TAPS筛选。在这313名患者中，76（24.3％）遵守说明，237（75.7％）未正确遵循说明。在237名没有正确遵循指示的受访者中，166（70％）回答了更多问题，而71（30％）回答了比TAPS第2部分要求的更少的问题。在237名不遵守问卷指导的患者中，44（18.6％）的回应方式与他们在筛选器的第1部分中的回应相矛盾，并最终影响了他们的整体TAPS得分。
结论：在最初为电子用途开发的纸上填写物质使用筛选器时，患者遵守问卷说明是具有挑战性的。选择基于测量的护理的PROM时，重要的是要考虑问卷的结构以及如何管理PROM，以确定是否需要实施对PROM自我管理的额外支持。
目的：本研究旨在检查患者自行服用2部分物质使用筛查剂的可行性-烟草，酒精,处方药,和其他物质（TAPS）-在纸上。该筛选器最初是为电子管理而开发的。它从有限数量的问题开始，并根据个人的回答跳过或反射到其他问题。在这项研究中,由于城市健康安全网医院的紧急护理行为健康诊所的电子管理障碍,TAPS适用于纸质使用.
方法：从2021年8月到2022年3月，研究人员收集了未识别的TAPS论文回答，并跟踪TAPS完成率和对问卷说明的依从性。随后进行了回顾性图表审查，以获取2021年8月至2022年3月期间到诊所就诊的患者的人口统计学信息。由于从TAPS响应中收集的初始信息被取消识别，人口统计信息与研究人员跟踪的单个TAPS筛查员没有关联.
结果：共有507例新患者在临床就诊，平均年龄为38.7（SD16.6）岁。总之,258例（50.9%）患者为男性。他们主要是黑人（n=212，41.8%），白色(n=152,30%),非西班牙裔或非拉丁裔（n=403，79.5%）。大多数患者是公共保险（n=411，81.1％）。在这507名患者中，313（61.7％）完成了TAPS筛选。在这313名患者中，76（24.3％）遵守说明，237（75.7％）未正确遵循说明。在237名没有正确遵循指示的受访者中，166（70％）回答了更多问题，而71（30％）回答了比TAPS第2部分要求的更少的问题。在237名不遵守问卷指导的患者中，44（18.6％）的回应方式与他们在筛选器的第1部分中的回应相矛盾，并最终影响了他们的整体TAPS得分。
结论：在最初为电子用途开发的纸上填写物质使用筛选器时，患者遵守问卷说明是具有挑战性的。选择基于测量的护理的PROM时，重要的是要考虑问卷的结构以及如何管理PROM，以确定是否需要实施对PROM自我管理的额外支持。
