PMID- 24731538 OWN - NLM STAT- MEDLINE DCOM- 20150206 LR - 20220318 IS - 1879-0046 (Electronic) IS - 0376-8716 (Linking) VI - 139 DP - 2014 Jun 1 TI - Development of the Addiction Dimensions for Assessment and Personalised Treatment (ADAPT). PG - 121-31 LID - S0376-8716(14)00794-7 [pii] LID - 10.1016/j.drugalcdep.2014.03.018 [doi] AB - BACKGROUND: Convergent research reveals heterogeneity in substance use disorders (SUD). The Addiction Dimensions for Assessment and Personalised Treatment (ADAPT) is designed to help clinicians tailor therapies. METHODS: Multicentre study in 21 SUD clinics in London, Birmingham (England) and Adelaide (Australia). 132 clinicians rated their caseload on a beta version with 16 ordinal indicators of addiction severity, health and social problem complexity, and recovery strengths constructs. In Birmingham, two in-treatment outcomes were recorded after 15-months: 28-day drug use (Treatment Outcome Profile; n=703) and Global Assessment of Functioning (GAF; DSM-IV Axis V; n=695). Following item-level screening (inter-rater reliability [IRR]; n=388), exploratory structural equation models (ESEM), latent profile analysis (LPA), and mixed-effects regression evaluated construct, concurrent and predictive validity characteristics, respectively. RESULTS: 2467 patients rated (majority opioid or stimulant dependent, enrolled in opioid medication assisted or psychological treatment). IRR-screening removed two items and ESEM models identified and recalibrated remaining indicators (root mean square error of approximation 0.066 [90% confidence interval 0.055-0.064]). Following minor re-specification and satisfactory measurement invariance evaluation, ADAPT factor scores discriminated patients by sample, addiction therapy and drug use. LPA identified three patient sub-types: Class 1 (moderate severity, moderate complexity, high strengths profile; 46.9%); Class 2 (low severity, low complexity, high strengths; 25.4%) and Class 3 (high severity, high complexity, low strengths; 27.7%). Class 2 had higher GAF (z=4.30). Class 3 predicted follow-up drug use (z=2.02) and lower GAF (z=3.51). CONCLUSION: The ADAPT is a valid instrument for SUD treatment planning, clinical review and outcome evaluation. Scoring and application are discussed. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - Marsden, John AU - Marsden J AD - Addictions Department, Institute of Psychiatry, King's College London, United Kingdom; South London and Maudsley NHS Mental Health Foundation Trust, United Kingdom; Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. Electronic address: john.marsden@kcl.ac.uk. FAU - Eastwood, Brian AU - Eastwood B AD - Addictions Department, Institute of Psychiatry, King's College London, United Kingdom; Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Ali, Robert AU - Ali R AD - Drug and Alcohol Services South Australia and Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Australia. FAU - Burkinshaw, Pete AU - Burkinshaw P AD - Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Chohan, Gagandeep AU - Chohan G AD - Birmingham and Solihull NHS Mental Health Foundation Trust, United Kingdom. FAU - Copello, Alex AU - Copello A AD - Birmingham and Solihull NHS Mental Health Foundation Trust, United Kingdom. FAU - Burn, Daniel AU - Burn D AD - Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Kelleher, Michael AU - Kelleher M AD - Addictions Department, Institute of Psychiatry, King's College London, United Kingdom; South London and Maudsley NHS Mental Health Foundation Trust, United Kingdom; Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Mitcheson, Luke AU - Mitcheson L AD - Addictions Department, Institute of Psychiatry, King's College London, United Kingdom; South London and Maudsley NHS Mental Health Foundation Trust, United Kingdom; Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Taylor, Steve AU - Taylor S AD - Alcohol, Drug and Tobacco Division, Health and Wellbeing Directorate, Public Health England, United Kingdom. FAU - Wilson, Nick AU - Wilson N AD - Blenheim CDP, United Kingdom. FAU - Whiteley, Chris AU - Whiteley C AD - East London NHS Foundation Trust, United Kingdom. FAU - Day, Edward AU - Day E AD - Addictions Department, Institute of Psychiatry, King's College London, United Kingdom; Birmingham and Solihull NHS Mental Health Foundation Trust, United Kingdom; School of Clinical & Experimental Medicine, University of Birmingham, United Kingdom. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20140322 PL - Ireland TA - Drug Alcohol Depend JT - Drug and alcohol dependence JID - 7513587 SB - IM MH - Adult MH - Amphetamine-Related Disorders/diagnosis/psychology/therapy MH - Cross-Sectional Studies MH - Female MH - Humans MH - Male MH - Opioid-Related Disorders/diagnosis/psychology/therapy MH - *Psychiatric Status Rating Scales/standards MH - Reproducibility of Results MH - Sensitivity and Specificity MH - Severity of Illness Index MH - Substance-Related Disorders/*diagnosis/psychology/therapy OTO - NOTNLM OT - ADAPT OT - Assessment OT - Personalised OT - Substance use disorder OT - Treatment EDAT- 2014/04/16 06:00 MHDA- 2015/02/07 06:00 CRDT- 2014/04/16 06:00 PHST- 2013/12/16 00:00 [received] PHST- 2014/02/03 00:00 [revised] PHST- 2014/03/11 00:00 [accepted] PHST- 2014/04/16 06:00 [entrez] PHST- 2014/04/16 06:00 [pubmed] PHST- 2015/02/07 06:00 [medline] AID - S0376-8716(14)00794-7 [pii] AID - 10.1016/j.drugalcdep.2014.03.018 [doi] PST - ppublish SO - Drug Alcohol Depend. 2014 Jun 1;139:121-31. doi: 10.1016/j.drugalcdep.2014.03.018. Epub 2014 Mar 22.