Paul J Joudrey1, Benjamin A Howell2, Kate Nyhan3, Ali Moravej4, Molly Doernberg4, Joseph S Ross5, Emily A Wang6. 1. Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States. Electronic address: paul.joudrey@yale.edu. 2. Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; VA Connecticut Healthcare System, West Haven, CT. United States; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; SEICHE Center, Yale School of Medicine, New Haven, CT, United States. 3. Center for Biomedical Data Science, Cushing/Whitney Medical Library, Yale School of Medicine. 4. Yale School of Public Health, New Haven, CT, United States. 5. Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, United States. 6. Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; SEICHE Center, Yale School of Medicine, New Haven, CT, United States.
Abstract
BACKGROUND: Adult drug courts are growing in popularity within the Unites States, but the quality of substance use treatment within drug court programs and the impact of drug courts on health and substance use treatment outcomes is largely unknown. We appraised the quality of United States adult drug court process evaluations and the inclusion of measures of substance use treatment quality. METHODS: We systematically reviewed the adult drug court evaluations between 2008 and 2018 in accordance with recommended strategies for systematic gray literature search. We appraised evaluation quality using the Evidence for Policy and Practice Information and Coordination Center tool for process evaluations. We extracted recommended measures of substance use treatment quality, including measures related to screening and monitoring, diagnosis, service availability, service utilization, and outcomes. RESULTS: Our search identified 112 evaluations. Process measures were included within 68 evaluations, 45% of which had poor data reliability. We found that less than 10% of evaluations reported substance use treatment quality measures related to service utilization, overdose, and mortality, while more than 75% contained criminal justice measures, including program graduation (completion of criminal justice proceedings) and participant recidivism. CONCLUSIONS: We found low uptake of measures of substance use treatment quality. The absence of data call into question the ability of drug courts to stem harmful substance use related health outcomes.
BACKGROUND: Adult drug courts are growing in popularity within the Unites States, but the quality of substance use treatment within drug court programs and the impact of drug courts on health and substance use treatment outcomes is largely unknown. We appraised the quality of United States adult drug court process evaluations and the inclusion of measures of substance use treatment quality. METHODS: We systematically reviewed the adult drug court evaluations between 2008 and 2018 in accordance with recommended strategies for systematic gray literature search. We appraised evaluation quality using the Evidence for Policy and Practice Information and Coordination Center tool for process evaluations. We extracted recommended measures of substance use treatment quality, including measures related to screening and monitoring, diagnosis, service availability, service utilization, and outcomes. RESULTS: Our search identified 112 evaluations. Process measures were included within 68 evaluations, 45% of which had poor data reliability. We found that less than 10% of evaluations reported substance use treatment quality measures related to service utilization, overdose, and mortality, while more than 75% contained criminal justice measures, including program graduation (completion of criminal justice proceedings) and participant recidivism. CONCLUSIONS: We found low uptake of measures of substance use treatment quality. The absence of data call into question the ability of drug courts to stem harmful substance use related health outcomes.
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