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EXIT FROM TREATMENT INDICATOR

EXIT FROM TREATMENT INDICATOR. GREEK REITOX FOCAL POINT 3-4 OCTOBER 2002 Lisbon. EXIT FROM TREATMENT INDICATOR. Pompidou Group Project: Development and Testing of Exit from Treatment Form – ETI* for Clients in Drug Abuse Treatment.

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EXIT FROM TREATMENT INDICATOR

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  1. EXIT FROM TREATMENT INDICATOR GREEK REITOX FOCAL POINT 3-4 OCTOBER 2002 Lisbon

  2. EXIT FROM TREATMENT INDICATOR Pompidou Group Project: Development and Testing of Exit from Treatment Form – ETI* for Clients in Drug Abuse Treatment *TDF (Treatment Discharge Form)  ETI (Exit from Treatment Indicator)

  3. EXIT FROM TREATMENT INDICATOR • Main objectives: • 1st phase: • · To develop and test a standard form for collecting core data on clients at the exit from treatment (completed, premature discharge or drop out) • · To register core information for follow-up • · Test the feasibility of linking data at entry (TDI) with those at the exit (ETI) through anonymous identifiers

  4. EXIT FROM TREATMENT INDICATOR • Main objectives: • 2nd phase: • · To test the relevance of characteristics at entry to those at exit in order to identify variables that might have an impact on the mode of discharge and the situation of the client upon it • · To test the feasibility of developing a Treatment Retention Registration System (TRRS)

  5. EXIT FROM TREATMENT INDICATOR • PARTICIPANTS: 15 cities from 6 countries • France (Brest, Metz, Marseille, Nice, Paris, St Etienne) • Greece (Athens, Thessaloniki) • Italy (Rome) • Russia (Moscow, St Petersburg) • Slovenia (Murska Sobota) • UK (Salford, Manchester)

  6. EXIT FROM TREATMENT INDICATOR 3 Questionnaires: • ETI Core Item List: information for the client • Treatment Unit’s/Programme’s Director: information for the programme • Key worker’s questionnaire: for evaluation of the ETI

  7. EXIT FROM TREATMENT INDICATOR 12 ITEMS: • City • Treatment unit name • Client identifier • Type of treatment unit (substitution – drug free, inpatient – outpatient) • Date of intake • Date of discharge/last contact with client • Type of contact with this unit (old – new client) • Type of admission (regular – priority list, judicial etc) • Special population subgroup (adolescent, probation, dual diagnosis) • Type of treatment the client followed (detoxification, substitution, drug-free, advice etc) • Mode of discharge (completed, drop out, discharge, referral, deceased, change of residence, imprisoned) • Situation of client upon discharge (drug use, physical – psychological health, judiciary, social relationships, employment, housing)

  8. EXIT FROM TREATMENT INDICATOR GREECE Programs participating: 2 substitution programs in Athens (outpatient) 1 drug – free program in Athens (outpatient) 1 drug – free program in Thessaloniki (inpatient) • Forms collected: • 81 Discharge Forms: 62 from substitution • 19 from drug-free

  9. EXIT FROM TREATMENT INDICATOR GREECE • Results • 40,8% of data already exists (the highest among countries) • missing values per item varied from 1,2% to 9,8% • the highest: special population subgroup

  10. EXIT FROM TREATMENT INDICATOR GREECE • Efficiency of identifiers (TDI – ETI): • Ø 74 out of 81 (91,4%) clients matched • Ø mean time between intake and discharge: 13 months • Type of contact: • Ø 71 (87,7%) new clients • Ø 6 (7,4%) old clients • Type of admission: • Ø 68 (83,9%) regular waiting list • Ø 12 (14,8%) priority

  11. EXIT FROM TREATMENT INDICATOR GREECE Special population subgroup: Ø 64 (79%) no special subgroup Ø 8 (9,9%) dual diagnosis Ø 1 (1,2%) probation or parole Type of treatment (more than one choice): Ø 51 (63%) advice/counseling Ø 39 (48,1%) maintenance Ø 18 (22,2%) medicament free therapy Ø 11 (13,5%) detoxification

  12. EXIT FROM TREATMENT INDICATOR GREECE Mode of discharge: Ø 30 (37%) premature discharge Ø 22 (27,2%) treatment completed Ø 8 (9,9%) referral Drug situation upon discharge: Ø 29 (35,8%) drug free Ø 27 (33,3%) worsened Ø 15 (18,5%) improved

  13. EXIT FROM TREATMENT INDICATOR GREECE Health situation: Ø 34 (42%) improved Ø 32 (39,5%) stable Ø 13 (165) worsened Judiciary situation: Ø 52 (64,2%) no judicial involvement Ø 18 (22,2%) awaiting trial Ø 6 (7,4%) missing

  14. EXIT FROM TREATMENT INDICATOR GREECE Psychological situation: Ø 29 (35,8%) improved Ø 28 (34,6%) stable Ø 21 (25,9%) worsened Social relationships: Ø 39 (48,1%) stable Ø 26 (32,1%) improved Ø 15 (18,5%) worsened

  15. EXIT FROM TREATMENT INDICATOR GREECE Employment situation: Ø 39 (48,1%) unemployed Ø 25 (30,9%) part time Ø 14 (17,3%) full time Housing/living conditions: Ø 49 (60,5%) with family/relatives Ø 19 (23,5%) own apartment Ø 5 (6,2%) sharing apartment

  16. EXIT FROM TREATMENT INDICATOR GREECE • Results from 66 Evaluation Forms: • quick and very easy to complete • item 10 and 12 most difficult Further comments: • the client’s disposition to re-approach the Unit • the client’s marital status • add categories to special population subgroup

  17. EXIT FROM TREATMENT INDICATOR STRENGTHS Ø promotes thinking about the possible uses of treatment discharge data Ø comparable results for further comparisons, treatment quality evaluation and rehabilitation prognosis Ø have proved the feasibility of the instrument in out-patient and in-patient settings Ø offers the basis for follow-up after exit from treatment

  18. EXIT FROM TREATMENT INDICATOR LIMITS TO EVALUATING Ø short duration of the development phase of the instrument Ø the limited number of participating countries did not permit a broad enough range of opinion to be canvassed Ø the qualitative character of some items

  19. EXIT FROM TREATMENT INDICATOR • FURTHER CONSIDERATIONS • incorporate feedback from the agents • great obstacles in evaluation of treatment: reconsideration or readjustment of targets

  20. The End

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