Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres.
AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS:...
| Publicado en: | Addiction Vol. 102; no. 3; pp. 466 - 475 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2007
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105911597&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105911597 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Mar2007 vid: 102 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105911597 105911597 2009904226 10.1111/j.1360-0443.2006.01716.x NLM17298655 105911597 ppf: 466 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres. aug: au: Merkx MJ Schippers GM Koeter MJ Vuijk PJ Oudejans S de Vries CC van den Brink W affil: Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands. merkx@aiar.nl sug: subj: Cognitive Therapy Health Services Needs and Demand Administration Quality of Health Care Administration Substance Use Disorders Therapy Substance Use Rehabilitation Programs Administration Adult Female Guideline Adherence Male Medical Practice, Evidence-Based Middle Age Netherlands Pilot Studies Practice Guidelines Prospective Studies Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS: All 4394 referrals to the two SATCs in 2003. MEASUREMENTS: Baseline patient characteristics needed for treatment allocation according to protocol, treatment allocation according to matching protocol, treatment allocation according to actual level of care (LOC) entered. ANALYSIS: Comparison of recommended and actual LOC entered. Evaluation of reasons for observed differences between recommended and actual LOC entered. FINDINGS: Data needed for treatment allocation according to protocol were available for 2269 (51.6%) patients. Data needed for evaluation of actual LOC entered were available for 1765 (40.2%) patients. Of these patients, 1089 (60.8%) were allocated according to protocol: 48.4% based on the guideline algorithm and 12.4% based on clinically justified deviations from this algorithm. The main reason for deviation was a different appraisal of addiction severity, made by the intake counsellor compared to the protocol. CONCLUSION: The feasibility of guideline-based treatment allocation is seriously limited due to inadequate data collection of patient characteristics and suboptimal guideline-based treatment allocation. As a consequence, only 24.4% of the patients could be evaluated as being matched properly to the treatment planned. The results indicate several barriers which limit the adequate implementation of patient-treatment-matching guidelines: problems in the infrastructure of data collection and storage and the inertia of intake staff who did not adhere to the guidelines for assessment and matching. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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