Objective 3.2: Develop and test metrics for measuring the quality and efficacy of treatment
One of the principles of current health reform efforts is that health care may be improved through the development and use of clinical quality measures. New health care payment and delivery models that create financial incentives based on quality performance measures are emerging. Efforts are underway to incorporate these types of measures into a "learning health care system" that continuously monitors performance and strives to rapidly adjust practices to improve outcomes.
In 2006, the Institute of Medicine recommended developing and implementing a quality measurement and reporting infrastructure as part of an overall strategy for enhancing the care provided in the field of SUD treatment.107 The creation of valid and reliable quality measures that can be monitored and acted upon to drive improvements in identification and treatment of people with SUDs is a critical mechanism through which the behavioral health field can contribute to the ongoing evolution of the health care system.
Currently, almost all clinical quality measures used to evaluate addiction treatment are process measures that evaluate the services provided—for example, whether or not a patient was counseled about the medications available for opioid use disorder treatment. There is a significant need to develop and test outcome measures that evaluate patient response to treatment.
In addition to use in the health care system, valid outcome measures that can serve as end-point measures for clinical trials of therapeutics for SUDs are also urgently needed.108 Over the next 5 years, NIDA will prioritize the development of metrics that measure the quality and efficacy of addiction treatments, leveraging existing measurement standards—such as the NIH Patient Reported Outcomes Measurement Information System (PROMIS®)—when possible.
- Identify target metrics that are effective indicators of long-term treatment efficacy
- Develop and test new end-point measures (other than abstinence) for clinical trials of SUD therapeutics
- Develop and test clinical quality measures for implementation in diverse health care settings
- Determine the influence of health care provider training and experience on patient outcomes