The ADOM tool

The alcohol and drug outcome measure (ADOM) is a brief outcome measure. It consists of 18 questions relevant to New Zealand alcohol and other drug (AOD) services. Service users and providers were involved in its development. This group included Maori and Pacific service users. The tool can be used in a range of AOD treatment services. It focuses on a range of substances. The questionnaire is designed for service users and clinicians to complete together.

The work on the initial development of ADOM has been completed and a report with recommendations on ADOM implementation is currently with the Ministry of Health for consideration.

What is ADOM?

The ADOM is a two-part questionnaire for use with AOD treatment service users. It collects information about changes in substance use and aspects of health and functioning. Part A has questions about the type and frequency of alcohol and other drug use. Part B has questions about how the use of alcohol and other drugs affects the person’s life in different ways, for example, relationships, work, health and accommodation.

Why collect this information?

ADOM results can show what changes have occurred for AOD service users since receiving AOD treatment services. This helps service users to review their goals. Service users can also discuss the results with the staff member working with them. This may result in adjusting their treatment or intervention plan. The ADOM results also show how well the service is meeting the needs of service users. The results can identify what improvements could be made.

Who should use ADOM?

The ADOM was targeted for use with adults attending mainstream AOD treatment services including outpatient, day patient, detoxification and opioid substitution treatment programmes. The service user and clinician/practitioner need to complete the ADOM together. As a post-treatment outcome measure, the ADOM could be completed via telephone contact. When used to assist treatment planning, the ADOM should be used during reviews of treatment progress with service users and where possible their significant others and whanau.

Development of the ADOM

Who developed the ADOM?

The ADOM was developed by the Alcohol and Drug Outcomes Project (ADOPT) team. The project team included the Clinical Research and Resource Centre and Auckland Community Alcohol and Drug Services from Waitemata District Health Board in collaboration with the National Addiction Centre (NAC), University of Otago. An advisory board, including AOD service users representatives, assisted the ADOPT team.

Why develop another AOD outcome measure?

We need to monitor service user outcomes such as reducing substance use and improving mental health along with personal and social role functioning. To do this we need relevant and effective measurement tools. The ADOM has been developed to meet the specific needs of New Zealand AOD treatment service users and support recovery. It will enhance an outcomes focused culture within AOD and mental health services.

How was the ADOM developed?

AOD experts were consulted to create the questionnaire. It was then tested with AOD service users and staff. Changes were made based on their feedback. The tool then underwent psychometric testing to assess its suitability as a routine outcome measure. The psychometric testing showed that Part A of the questionnaire is a valid and reliable measurement tool for use in AOD services. However, Part B requires further trialling.

Using the ADOM with mental health service users

Research has shown that there is a high level of AOD misuse among people with mental health problems (Sinclair, Latifi & Latifi, 2008; Weaver et al, 2003). However, more testing of the ADOM is required to see whether it is suitable or valid for users of mental health services who have AOD issues.

Currently the ADOM report and measure are freely available for download below.

Factsheet PDF (60kb)
Summary report PDF (214kb)
Full report PDF (658kb)

To download the measure (PDF, 53KB) please fill in the form at the bottom of this page. Your details are collected so that we can email you if a new version of the measure is released.

What is the next step for ADOM?

Following the testing process, the following recommendations are made about ADOM.

ADOM Part A should be considered for use as a routine outcome measure across the New Zealand AOD treatment sector. The Ministry of Health will decide whether to mandate Part A for use in AOD settings.
ADOM Part B is not currently validated. ADOM Part B can be used by New Zealand AOD treatment services at their discretion. It is a potentially useful tool that may assist clinical decision making at the level of the service user/clinician relationship.
ADOM Part A has not been validated for use within mental health services in New Zealand. It could be considered as a routine outcome measure in mental health services here in recognition of the high level of substance misuse amongst clients attending mental health services. This will require replication of the testing process within the mental health services sector.

The Ministry of Health reviewed the implementation of ADOM nationally and indicated in February 2010 that they will endorse the use of the ADOM – AOD outcomes measure for local use, and when part two of the tool is validated that they will move to mandate the tool for national collection.

ADOM was used in the outcomes evaluation of the Effective Interventions Project of the CADS Offender Program (Waitemata District Health Board). The pilot was designed to strengthen the current relationship with Northern Regions Corrections, as well as enhance the efficiency and effectiveness of alcohol and other drug (AOD) treatment to offenders in prison and serving community based sentences. The analysis has shown a reduction in the frequency and amount of substance use. Most clients reported that this had helped them reduce their offending, and were motivated to address their substance use. Anecdotally, there has also been generally positive feedback from both clients and clinicians involved in the project. Clinicians have reported that administering the ADOM, in particular Part A, has been straight forward and easy to complete by telephone.

More information about the research project is available in the Te Pou Knowledge Exchange.

Te Pou is keen to hear about the experiences of any service using the tool.

Further information

For more information please contact Jane Vanderpyl, national research manager.

Files

ADOM measure

Page last updated: 24 June 2010