BACKGROUND: Substance use, a leading cause of illness and death, is underidentified in medical practice. OBJECTIVE: The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) tool was developed to address the need for a brief screening and assessment instrument that includes all commonly used substances and fits into clinical workflows. The goal of this study was to assess the performance of the TAPS tool in primary care patients. DESIGN: Multisite study, conducted within the National Drug Abuse Treatment Clinical Trials Network, comparing the TAPS tool with a reference standard measure. (ClinicalTrials.gov: NCT02110693). SETTING: 5 adult primary care clinics. PARTICIPANTS: 2000 adult patients consecutively recruited from clinic waiting areas. MEASUREMENTS: Interviewer- and self-administered versions of the TAPS tool were compared with a reference standard, the modified World Mental Health Composite International Diagnostic Interview (CIDI), which measures problem use and substance use disorder (SUD). RESULTS: Interviewer- and self-administered versions of the TAPS tool had similar diagnostic characteristics. For identifying problem use (at a cutoff of 1+), the TAPS tool had a sensitivity of 0.93 (95% CI, 0.90 to 0.95) and specificity of 0.87 (CI, 0.85 to 0.89) for tobacco and a sensitivity of 0.74 (CI, 0.70 to 0.78) and specificity of 0.79 (CI, 0.76 to 0.81) for alcohol. For problem use of illicit and prescription drugs, sensitivity ranged from 0.82 (CI, 0.76 to 0.87) for marijuana to 0.63 (CI, 0.47 to 0.78) for sedatives; specificity was 0.93 or higher. For identifying any SUD (at a cutoff of 2+), sensitivity was lower. LIMITATIONS: The low prevalence of some drug classes led to poor precision in some estimates. Research assistants were not blinded to participants' TAPS tool responses when they administered the CIDI. CONCLUSION: In a diverse population of adult primary care patients, the TAPS tool detected clinically relevant problem substance use. Although it also may detect tobacco, alcohol, and marijuana use disorders, further refinement is needed before it can be recommended broadly for SUD screening. PRIMARY FUNDING SOURCE: National Institute on Drug Abuse.
BACKGROUND: Substance use, a leading cause of illness and death, is underidentified in medical practice. OBJECTIVE: The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) tool was developed to address the need for a brief screening and assessment instrument that includes all commonly used substances and fits into clinical workflows. The goal of this study was to assess the performance of the TAPS tool in primary care patients. DESIGN: Multisite study, conducted within the National Drug Abuse Treatment Clinical Trials Network, comparing the TAPS tool with a reference standard measure. (ClinicalTrials.gov: NCT02110693). SETTING: 5 adult primary care clinics. PARTICIPANTS: 2000 adult patients consecutively recruited from clinic waiting areas. MEASUREMENTS: Interviewer- and self-administered versions of the TAPS tool were compared with a reference standard, the modified World Mental Health Composite International Diagnostic Interview (CIDI), which measures problem use and substance use disorder (SUD). RESULTS: Interviewer- and self-administered versions of the TAPS tool had similar diagnostic characteristics. For identifying problem use (at a cutoff of 1+), the TAPS tool had a sensitivity of 0.93 (95% CI, 0.90 to 0.95) and specificity of 0.87 (CI, 0.85 to 0.89) for tobacco and a sensitivity of 0.74 (CI, 0.70 to 0.78) and specificity of 0.79 (CI, 0.76 to 0.81) for alcohol. For problem use of illicit and prescription drugs, sensitivity ranged from 0.82 (CI, 0.76 to 0.87) for marijuana to 0.63 (CI, 0.47 to 0.78) for sedatives; specificity was 0.93 or higher. For identifying any SUD (at a cutoff of 2+), sensitivity was lower. LIMITATIONS: The low prevalence of some drug classes led to poor precision in some estimates. Research assistants were not blinded to participants' TAPS tool responses when they administered the CIDI. CONCLUSION: In a diverse population of adult primary care patients, the TAPS tool detected clinically relevant problem substance use. Although it also may detect tobacco, alcohol, and marijuana use disorders, further refinement is needed before it can be recommended broadly for SUD screening. PRIMARY FUNDING SOURCE: National Institute on Drug Abuse.
Authors: Li-Tzy Wu; Marvin S Swartz; Jeng-Jong Pan; Bruce Burchett; Paolo Mannelli; Chongming Yang; Dan G Blazer Journal: Gen Hosp Psychiatry Date: 2012-07-21 Impact factor: 3.238
Authors: Jennifer McNeely; Shiela M Strauss; John Rotrosen; Arianne Ramautar; Marc N Gourevitch Journal: Addiction Date: 2015-10-26 Impact factor: 6.526
Authors: Leanne Hides; Sue M Cotton; Gregor Berger; John Gleeson; Colin O'Donnell; Tina Proffitt; Patrick D McGorry; Dan I Lubman Journal: Addict Behav Date: 2009-03-06 Impact factor: 3.913
Authors: Evelyn P Whitlock; Michael R Polen; Carla A Green; Tracy Orleans; Jonathan Klein Journal: Ann Intern Med Date: 2004-04-06 Impact factor: 25.391
Authors: William S John; He Zhu; Paolo Mannelli; Geetha A Subramaniam; Robert P Schwartz; Jennifer McNeely; Li-Tzy Wu Journal: Drug Alcohol Depend Date: 2018-11-26 Impact factor: 4.492
Authors: R P Schwartz; J McNeely; L T Wu; G Sharma; A Wahle; C Cushing; C D Nordeck; A Sharma; K E O'Grady; J Gryczynski; S G Mitchell; R L Ali; J Marsden; G A Subramaniam Journal: J Subst Abuse Treat Date: 2017-01-31
Authors: Elizabeth C Saunders; Sarah K Moore; Olivia Walsh; Stephen A Metcalf; Alan J Budney; Emily Scherer; Lisa A Marsch Journal: J Subst Abuse Treat Date: 2020-01-21
Authors: William S John; Kiran Grover; Lawrence H Greenblatt; Robert P Schwartz; Li-Tzy Wu Journal: J Gen Intern Med Date: 2019-11-08 Impact factor: 5.128
Authors: Derek D Satre; Alexandra N Anderson; Amy S Leibowitz; Tory Levine-Hall; Sally Slome; Jason Flamm; C Bradley Hare; Jennifer McNeely; Constance M Weisner; Michael A Horberg; Paul Volberding; Michael J Silverberg Journal: Contemp Clin Trials Date: 2019-08-22 Impact factor: 2.226
Authors: Li-Tzy Wu; Jennifer McNeely; Geetha A Subramaniam; Kathleen T Brady; Gaurav Sharma; Paul VanVeldhuisen; He Zhu; Robert P Schwartz Journal: Drug Alcohol Depend Date: 2017-07-13 Impact factor: 4.492
Authors: Norah Mulvaney-Day; Tina Marshall; Kathryn Downey Piscopo; Neil Korsen; Sean Lynch; Lucy H Karnell; Garrett E Moran; Allen S Daniels; Sushmita Shoma Ghose Journal: J Gen Intern Med Date: 2017-09-25 Impact factor: 5.128
Authors: Theresa E Matson; Gwen T Lapham; Jennifer F Bobb; Eric Johnson; Julie E Richards; Amy K Lee; Katharine A Bradley; Joseph E Glass Journal: Drug Alcohol Depend Date: 2020-08-08 Impact factor: 4.492