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The primitive state of quality measures in addiction treatment and their application

Posted on 03-17-16 in Advocacy

The primitive state of quality measures in addiction treatment and their application

The struggle, when it comes to quality measures in addiction treatment, is not the development and implementation. The real challenge is in the development of measures based upon validity, comprehension and safety – measures that stimulate authentic increases in quality and avoid adverse unintended consequences.

A recent article published last year discusses how the progress of medical measurement technologies has also increasingly raised questions and doubts about their significance, understanding and the inadvertent consequences they generate.

Substance abuse treatment

Even though largely unacknowledged, a significant threat to the legitimacy of quality measures is deficient estimates of the actual prevalence of substance use disorder in a target population. This has continually resulted in faulty approximations of treatment coverage.

Most measures of substance use disorder (SUD) treatment quality are defined on the basis of diagnosis conventions. The issues, however, extend to operations and screening as well. Such differences in assessment or coding routines most often lead to disparity between the measured and the actual denominator prevalence.

If unnoticed, such discrepancies can greatly undermine the accuracy of high and low outliers. Ideally, the available data for the development of quality measures could be perfectly operationalized as per the evidence-based clinical processes and treatments. Yet, in reality, the struggle remains to not just enhance the validity of quality measures, but to incorporate them in a way that yields the intended results and benefits.

Steps to remedy

      1. It is vital to develop reality checks on the believability of measured denominator prevalence. If a huge integrated health care system in the U.S. has an obviously extraordinary occurrence of SUD diagnoses, then quality measures denominated on the basis of diagnosis should not be used for comparison.

2. There is a possibility for the development of substitute denominators that are less susceptible to divergences. Bradley and colleagues suggested that population-based denominators (e.g. number of patients diagnosed and treated/all patients) might encourage both identification and treatment.

Choosing wisely

The ABIM Foundation commenced Choosing Wisely, aiming to create a national dialogue that discourages improvident or unnecessary medical tests, treatments and procedures.

Choosing Wisely helps sponsor quality interaction between professionals and patients by encouraging patients to choose care that:

  • Is sustained by evidence
  • Does not reproduce results from other tests or procedures already received
  • Is safe
  • Is justly required

The conversations between providers and patients are based on the evidence-based recommendations of more than 70 specialty society partners. The program intends to facilitate sensible judgments about choosing the most suitable care based on patients’ individual needs and conditions.

About us

Sovereign Health is a leading behavioral health treatment provider devoted to the provision of evidence-based treatment for substance abuse disorders and mental illnesses. We aim to see our patients not just succeed in treatment but thrive in their daily lives as well. If you or a loved one is currently struggling to regain control of your life, help is just a phone call away.

About the author

Sana Ahmed is a staff writer for Sovereign Health Group. A journalist and social media savvy content developer with extensive research, print and on-air interview skills, Sana has previously worked as an editor for a business magazine and been an on-air news broadcaster. She writes to share the amazing developments from the mental health world and unsuccessfully attempts to diagnose her friends and family. For more information and other inquiries about this article, contact the author at