GREEK REITOX FOCAL POINT

3-4 OCTOBER 2002Lisbon

Pompidou Group Project: Development and Testing of Exit from Treatment Form

– ETI* for Clients in Drug Abuse Treatment

*TDF (Treatment Discharge Form) ETI (Exit from Treatment Indicator)

Main objectives:

1st phase: To develop and test a standard form for collecting core data on clients at the exit from treatment (completed, premature discharge or drop out)To register core information for follow-upTest the feasibility of linking data at entry (TDI) with those at the exit (ETI) through anonymous identifiers

Main objectives:

2nd phase:To test the relevance of characteristics at entry to those at exit in order to identify variables that might have an impact on the mode of discharge and the situation of the client upon itTo test the feasibility of developing a Treatment Retention Registration System (TRRS)

PARTICIPANTS: 15 cities from 6 countries

• France (Brest, Metz, Marseille, Nice, Paris, St Etienne) • Greece (Athens, Thessaloniki) • Italy (Rome)• Russia (Moscow, St Petersburg)• Slovenia (Murska Sobota) • UK (Salford, Manchester)

3 Questionnaires:

ETI Core Item List: information for the client

Treatment Unit’s/Programme’s Director: information for the programme

Key worker’s questionnaire: for evaluation of the ETI

12 ITEMS:CityTreatment unit nameClient identifierType of treatment unit (substitution – drug free, inpatient – outpatient)Date of intake Date of discharge/last contact with clientType of contact with this unit (old – new client)Type of admission (regular – priority list, judicial etc)Special population subgroup (adolescent, probation, dual diagnosis)Type of treatment the client followed (detoxification, substitution, drug-free, advice etc)Mode of discharge (completed, drop out, discharge, referral, deceased, change of residence, imprisoned)Situation of client upon discharge (drug use, physical – psychological health, judiciary, social relationships, employment, housing)

Programs participating:

2 substitution programs in Athens (outpatient)1 drug – free program in Athens (outpatient)1 drug – free program in Thessaloniki (inpatient)

Forms collected:

81 Discharge Forms: 62 from substitution 19 from drug-free

Results

40,8% of data already exists (the highest among countries)missing values per item varied from 1,2% to 9,8%the highest: special population subgroup

Efficiency of identifiers (TDI – ETI):74 out of 81 (91,4%) clients matchedmean time between intake and discharge: 13 months

Type of contact: 71 (87,7%) new clients6 (7,4%) old clients

Type of admission:68 (83,9%) regular waiting list12 (14,8%) priority

Special population subgroup:64 (79%) no special subgroup8 (9,9%) dual diagnosis1 (1,2%) probation or parole

Type of treatment (more than one choice):51 (63%) advice/counseling39 (48,1%) maintenance18 (22,2%) medicament free therapy11 (13,5%) detoxification

Mode of discharge:30 (37%) premature discharge22 (27,2%) treatment completed8 (9,9%) referral

Drug situation upon discharge:29 (35,8%) drug free27 (33,3%) worsened15 (18,5%) improved

Health situation:34 (42%) improved32 (39,5%) stable13 (165) worsened

Judiciary situation:52 (64,2%) no judicial involvement18 (22,2%) awaiting trial6 (7,4%) missing

Psychological situation:29 (35,8%) improved28 (34,6%) stable21 (25,9%) worsened

Social relationships:39 (48,1%) stable26 (32,1%) improved15 (18,5%) worsened

Employment situation:39 (48,1%) unemployed25 (30,9%) part time14 (17,3%) full time

Housing/living conditions:49 (60,5%) with family/relatives19 (23,5%) own apartment5 (6,2%) sharing apartment

Results from 66 Evaluation Forms:

quick and very easy to complete item 10 and 12 most difficult

Further comments:

the client’s disposition to re-approach the Unit the client’s marital status add categories to special population subgroup

have proved the feasibility of the instrument in out-patient and in-patient settings

offers the basis for follow-up after exit from treatment

comparable results for further comparisons, treatment quality evaluation and rehabilitation prognosis

STRENGTHS

promotes thinking about the possible uses of treatment discharge data

LIMITS TO EVALUATING

short duration of the development phase of the instrument

the limited number of participating countries did not permit a broad enough range of opinion to be canvassed

the qualitative character of some items

FURTHER CONSIDERATIONS

incorporate feedback from the agents

great obstacles in evaluation of treatment: reconsideration or readjustment of targets

The End