Celebrating a successful implementation

The Alcohol and Drug Outcome Measure (ADOM) is a tāngata whai ora led outcome measure, mandated for use in outpatient community alcohol and drug services.

ADOM provides service users with a way to rate and track key areas of change during their treatment journey. This includes changes in use of alcohol and other drugs, lifestyle and wellbeing and satisfaction with treatment progress and recovery.

There are some incredible results to celebrate just one year on from implementation:

  • 82 per cent of mandated teams are reporting ADOM use
  • 159 of the 194 teams mandated to report ADOM into PRIMHD are doing so
  • 23,754 ADOM collections have been submitted to PRIMHD, with 1,758 matched start to end ADOM collections reflecting full treatment episodes
  • over 460 ADOM’s are being submitted each week.

The way the sector has embraced ADOM is really encouraging, not only in terms of collection but also the great application of use.

ADOM and tāngata whai ora

ADOM is a self-rated measure, which means alcohol and other drug (AOD) practitioners support tāngata whai ora they are working with, to regularly rate how they are doing and to view the results using the ADOM feedback wheel.

Outcome measurement tools such as ADOM can be used very effectively in therapeutic engagement with tāngata whai ora.

The ADOM feedback wheel provides a clear focus for discussing and planning treatment and recovery options. The ADOM form, feedback wheel and outcomes graph builder are available for download from Te Pou on the ADOM tools page.

The ease of uptake and engagement by services speaks volumes about the value of this tool. There are also many stories that show how using ADOM has made a difference in helping people realise their own progress toward recovery.

The following stories have been shared with us by a NGO community-based service.

Jim’s story

Jim was referred by his probation officer as part of sentence conditions following incidents of drunk driving.  He presented at the service, feeling adamant he did not have a problem with alcohol. He maintained he had made his own changes prior to attending the community NGO service.

Jim completed a treatment start ADOM, and a follow-up review was completed at six weeks. Treatment and service engagement continued and a further four 3-month interval reviews occurred since Jim’s treatment started. Jim remains engaged in the service, in a recovery capacity.

At the start of treatment Jim’s recovery score was a 3/10, and he scored his satisfaction as ‘moderate’. At his last ADOM review this changed to a recovery score of 9/10 with satisfaction rated at ‘considerable’. Jim states he no longer drinks alcohol at all.  At each session the previous ADOM was referred as a basis for discussion.

It is clear using ADOM not only helped with Jim’s engagement and retention in treatment, but also gave him an insight into his own progress at each review meeting.

Henare’s story

Henare is 30 years old, with a use history spanning 20 years. Henare was a self-referral,  with an impending drink driving conviction. Henare engaged with the service for four months, completing ADOM at the service start, two reviews and an end ADOM.

At each session the counsellor reviewed ADOM, which Henare reported as really helpful.  On discharge Henare requested a copy of the feedback wheel with three of the reviews because he was so happy with how his recovery score had jumped from a 1/10 at treatment start to 8/10 on discharge.  His satisfaction with progress towards achieving his recovery goal went from ‘slightly’ satisfied at the start ADOM to ‘considerably’ satisfied at the end of treatment.

When Henare was initially assessed he was drinking 26 days out of 28. On discharge Henare reported drinking five of the last 28 days. He found the visual feedback meaningful and helped to identify and emphasise the progress along the pathway of recovery.

The visual aspect of the feedback wheel was useful in sessions and as take home ‘evidence’ of success.

Supporting implementation

Te Pou o te Whakaaro Nui and Matua Raki have worked with teams around the country to implement ADOM as an outcome measure. We are committed to continued support and embedding of this tool, developed and validated in New Zealand, for tāngata whai ora using our outpatient community alcohol and drug services.  

Along with foundational work leading up to the implementation of ADOM in services, some of the sector support provided since July 1 2015 has included:  

  • ADOM train the trainer training
  • refresher training
  • service visits and 1:1 support
  • establishing an e-mail group for ADOM trainers and champions (over 120 members)
  • publishing a frequently asked questions page online
  • production of three ADOM videos to demonstrate the ADOM in action, a consumer view of ADOM and how ADOM relates to kaupapa Māori services
  • establishing an advisory group to guide the reporting process – the group consists of representatives from the sector, the Ministry of Health, consumer groups, academics, researchers and analysts.

Plans for next 12 months

  • Continued sector support.
  • Further refresher training being held in September (Auckland) and November (Hamilton).
  • Regular distribution of ADOM reports using aggregated ADOM information (December 2016- Feb 2017 start date).
  • Scope and conduct an evaluation with tāngata whai ora in a service setting.
  • In collaboration with the Ministry of Health we will explore further validation and testing of ADOM in different settings, such as youth and residential.

Final thoughts

The AOD sector have enthusiastically adopted ADOM. There is commitment to using this tool with and for tāngata whai ora to support recovery . In the coming months Te Pou will produce meaningful reports based on data directly  collected  from tāngata whai ora, facilitated by practitioners. These reports will inform and encourage the sector even further regarding ADOM and the benefits it brings.

If you would like to showcase how ADOM has been useful in your treatment, recovery, or organisation, please contact Paul Hanton, ADOM lead, paul.hanton@tepou.co.nz.