Daryle Deering played a key role in bringing the Alcohol and Drug Outcome Measure (ADOM) to life. In this blog she talks about her decade long journey in developing ADOM.
The development of ADOM started just over a decade ago. Internationally there were increasing calls for people’s outcomes to be monitored while receiving alcohol and other drug (AOD) treatment provision.
The first phase of development, the Alcohol and Drug Outcomes Project (ADOPT) was funded by the then Mental Health Research and Development Strategy. Together with Dr Gail Robinson, I led this collaborative project between the University of Otago, Christchurch (National Addiction Centre (NAC), the Clinical Research and Resource Centre (CRRC), Waitemata DHB and the University of Auckland.
This initial work identified a strong endorsement for routine outcome monitoring with clients using a brief multidimensional instrument that would:
- be completed collaboratively between client and clinician/practitioner
- inform client treatment planning
- allow client progress to be monitored over time.
An initial document was recommended as a starting point for developing an outcomes measure.
In response to this endorsement, funding was provided to develop the prototype instrument in the second phase of development (ADOPT 2). Gail and I again led this collaborative project between CRRC (project fund holders) and NAC, overseen by an expert advisory group.
A range of people reviewed the tool and provided feedback including an expert clinical panel and a key stakeholder group including service managers, clinicians/practitioners and clients (including Māori and Pacific). We sought further feedback from 25 clients and their clinicians/practitioners, who were recruited from general AOD outpatient services in Christchurch and Auckland and an opioid substitution treatment service in Christchurch. This feedback was incorporated and the instrument was put to psychometric testing.
At this point it was recommended that section one (substance user) was suitable for use and section two (lifestyle and wellbeing) needed further testing.
Throughout the development phase the research team emphasised that the primary purpose of the tool (ADOM) should be a collaborative “checking in” of client progress, undertaken between a clinician/practitioner and a client and, where possible, his or her whānau. Most importantly the use of ADOM should be of value to clients, whānau, clinicians/practitioners and services.
From a research team perspective, the development of the ADOM has been an exciting and challenging journey. Within the context of current service provision, the inclusion of the two recovery questions (section three) in further field testing of ADOM by Te Pou has been an important addition.