The use of patient-reported outcomes in residential alcohol & drug services in Belgium: findings from the OMER-BE study

Background

Patient-Reported Outcome Measures (PROMs) provide information on the outcomes of treatment in health and social services. More recently, PROMs have been introduced in alcohol and drug services to assess symptoms, quality of life, physical functioning, and psychological well-being as experienced by service users. Research has shown that the routine use of PROMs has the potential to enhance treatment outcomes and management.

Methods

We set up a naturalistic, longitudinal, multicentric study (N=162) in two residential treatment modalities in Belgium (treatment wards in psychiatric hospitals (PC, n=82) and drug-free therapeutic communities (TC, n=80)), as part of the OMER-BE study (Outcome Measurement and Evaluation as a Routine practice in alcohol and other drug services in Belgium). Sociodemographic characteristics, clinical factors and PROMs were assessed at baseline (within 3 weeks after starting treatment). Additionally, we monitored these PROMs at 45, 90 and 180 days after baseline. Measurement of PROMs was based on a recently developed and internationally validated instrument (ICHOM Standard Set for Addictions, 2020).

Results

Baseline analyses revealed significant differences between participants from PCs and TCs with regard to primary substance use, educational level (p=.007), self-care (p=.005) and psychiatric comorbidities (PTSD and anxiety). At the 90 day follow-up, significantly improved PROMs compared to baseline were mental (p<.001) and physical health (p<.001), material resources (p<.001) and quality of life (p<.001), while PROMs related to family and social relationships moved in the opposite direction (p=.008). These trends differed depending on the treatment modality. Participants in PCs showed significant improvements on PROMs related to substance use (p=.021), while participants in TCs reported a decrease in measures of family and social relationships (p=.020) and an improvement on PROMs related to material resources (p=.015). Patient-reported measures of mental and physical health improved in both treatment modalities. 

Conclusion

The OMER-BE study highlights the importance of integrating patient-reported outcome measures for monitoring and improving the quality of addiction services. Additionally, the routine use of PROMs can contribute to more timely adjusted individual treatment and recovery trajectories.