背景:1990年,美国医学研究所在酒精和其他药物治疗领域推广了结局监测的原则,以提高证据的综合和研究质量。虽然已经制定和采用了各种国家成果衡量标准,尚未就成瘾标准测量达成全球共识。因此,建立国际共识是及时的。由国际健康结果测量联盟(ICHOM)召集,一个国际,多学科工作组审查了现有文献,并就寻求成瘾治疗的人的一套全球适用的最低结果衡量标准达成共识.方法:为此,来自5大洲11个国家的26名成瘾专家,包括有生活经验的人(n=5;19%),召开超过16个月(2018年12月至2020年3月)的会议,为一套最低限度的结果措施制定建议。一个结构化的,建立共识,采用改进的德尔菲法。在八次电视会议和随后的结构化在线协商中,提出并讨论了一套最低限度措施的循证建议。最终的集合由123名专业人员和34名具有国际生活经验的人员进行了审查。结果:最终基于共识的建议包括酒精,实质,和烟草使用障碍,以及12岁及以上人群的赌博和游戏障碍。推荐的结果领域是成瘾性障碍的频率和数量,症状负担,与健康相关的生活质量,全球运作,社会心理功能,以及整体身心健康和福祉。还建议使用标准病例混合(主持人)变量和测量时间点。结论:使用一致且有意义的结果测量有助于照顾者与患者的关系,共同决策,服务改进,基准测试,和证据综合,以评估成瘾治疗服务和传播最佳做法。建议结果的共识集可在全球医疗保健环境中免费使用。
Background: In 1990, the United States\' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global
consensus on standard measurement has been agreed for addiction. It is thus timely to build an international
consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured,
consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final
consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The
consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.