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Developing a Patient-Reported Outcom...

Okrant, Elisabeth.

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Developing a Patient-Reported Outcome Measure for Substance Use Disorder Recovery: A Person-Centered Approach to Monitoring Changes in Recovery Status.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Developing a Patient-Reported Outcome Measure for Substance Use Disorder Recovery: A Person-Centered Approach to Monitoring Changes in Recovery Status./
Author:	Okrant, Elisabeth.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	246 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-12, Section: B.
Contained By:	Dissertations Abstracts International80-12B.
Subject:	Public health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13858740
ISBN:	9781392231548

Developing a Patient-Reported Outcome Measure for Substance Use Disorder Recovery: A Person-Centered Approach to Monitoring Changes in Recovery Status.
Okrant, Elisabeth.

Developing a Patient-Reported Outcome Measure for Substance Use Disorder Recovery: A Person-Centered Approach to Monitoring Changes in Recovery Status. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 246 p.

Source: Dissertations Abstracts International, Volume: 80-12, Section: B.

Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2019.

This item must not be sold to any third party vendors.

Historically, substance use disorder (SUD) measures relied upon short-term, process-based treatment metrics. However, patient-reported outcomes measures (PROMs) offer a particularly salient means for measuring a construct like recovery because it is multidimensional, personally experienced, and cyclical in nature, necessitating a long-term approach to measurement. PROMs capture individuals' assessments of their health states, which is particularly helpful when assessing outcomes, as well as quality of care for people in recovery from SUD. This dissertation developed an SUD recovery PROM that could be used in clinical settings or as a self-management tool to measure changes in recovery over time.The recovery construct has yet to achieve definition consensus in the SUD field. Therefore, theories outside of substance use and addictions were used to inform the conceptual framework for measuring recovery. Public health's ecosocial theory defined the domains which influence recovery outcomes and the anthropological concept of liminality helped operationalize changes in recovery progress over time. In order to test the conceptual framework as viable for collecting data and measuring recovery, people with lived experience (PWLE) provided feedback about important elements to recovery through an on-line survey. After collecting 330 surveys and analyzing the data, an SUD recovery PROM was developed through an iterative strategy that eliminated overlapping concepts and retained only the items that had the most explanatory value to defining the underlying construct.The purpose of the study was to contribute to the discourse about which items and domains underlie the SUD recovery construct; develop a PROM that is flexible and sensitive to each person; and, allow for variability in people's perspectives and definitions of recovery, while capturing changes in recovery status over time. This research study accomplished these aims by reducing over 600 items related to recovery to eighteen of the most critical items associated with recovery outcomes. As a result, the PROM was designed with parsimony, a key factor in survey adoption in the clinical setting due to concern for patient burden. Furthermore, items that belonged to three recovery stages - early, active, and long-term - were included in the PROM to measure inter-personal recovery progress. The research findings indicated that items belonging to early and active recovery were state-based, whereas long-term recovery items were trait-based, suggesting that self-efficacy alone did not moderate recovery outcomes. Rather, the dissertation asserted that agency was most important to achieving social incorporation and should be explored additionally in future research. Both PWLE and behavioral health providers interviewed about the usefulness of the PROM contributed to the PROM's face validity by confirming key recovery elements across recovery stages were included.The study findings contributed to the SUD recovery and performance measurement literature by demonstrating that measuring outcomes requires innovation and commitment to quantifying constructs that are difficult to define. Defining recovery and the concepts that underlie the construct are only the first step when designing measures that are concordant with the patient-centered care philosophy. This PROM offers a prototype for incorporating subjective feedback toward achieving inter-personal and dynamic measurement strategies. The dissertation resulted in designing a PROM to fill a performance measurement gap, thereby enhancing accountability for health outcomes related to SUD and improving treatment quality.

ISBN: 9781392231548Subjects--Topical Terms:

534748
Public health.

Developing a Patient-Reported Outcome Measure for Substance Use Disorder Recovery: A Person-Centered Approach to Monitoring Changes in Recovery Status.
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