Validation of the TAPS-1: A Four-Item Screening Tool to Identify Unhealthy Substance Use in Primary Care PubMed

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taps screening tool

To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. Also, please view thefact sheetto learn about how to implement drug and alcohol screening. Universal screening for substance use by Peer Support Specialists in the Emergency Department is a pathway to buprenorphine treatment. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Birnbaum HG, White AG, Schiller M, Waldman T, Cleveland JM, Roland CL. Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease.

IT interventions to advance treatment for opioid and other addictions

The greatest discrepancy was for prescription medication misuse, which was 50% higher on the self-administered than the interviewer-administered format (12% vs. 8%). By the structure and content of the questions asked, a physician can identify specific substances that pose a problem to the patient’s health and well-being and so interventions/treatments can be tailored. For this reason, the TAPS tool shows promise for integration into the primary health care service as a screening method. However, as researchers noted, the precision of the TAPS tool in identifying substance use is dependent on the optimal cutoff score, as well as the prevalence of the drug classes. Therefore, before the TAPS tool can be integrated into primary care, these limitations must be addressed.

taps screening tool

The TAPS-1 and reference standard measures were asked by the same interviewers. We determined unhealthy substance use via a structured interview with items mapping to DSM-5 criteria. This is the appropriate standard, but remains an imperfect way of capturing a complex and nuanced phenomenon. The TAPS-1 groups marijuana with illicit drugs; however, several states have decriminalized or even legalized recreational marijuana use.

This secondary analysis of data from the TAPS Tool validation study describes the feasibility and acceptability of the myTAPS among primary care patients. Primary care providers are challenged with screening patients for multiple substances and assessing for substance use disorder, but current methods are cumbersome and time-consuming. Researchers developed the Tobacco, Alcohol, Prescription medication, and other Substance use tool, comprised of a 4-item initial screen and, if screen is positive for ≥1 substances, substance-specific follow-up assessment questions. The TAPS—either self or interviewer-administered—and reference standard Composite International Diagnostic Interview were completed in 2000 adult patients (mean age 46 years, 56% female, 12% Hispanic, 56% black) in 5 primary care clinics and compared. Shows the performance of the self-administered TAPS-1 for detecting unhealthy substance use at each severity threshold. For all four substance categories, the optimal cut-point on the TAPS-1 for detecting problem use was any use in the past 12 months (i.e., any response greater than ‘Never’).

CDC strives to move toward the goal of HAI elimination by using data to target prevention efforts and measure progress. The CDC TAP Strategy uses the CAD metric to identify healthcare facilities, or locations within facilities, with a disproportionate burden of HAIs above the Department of Health and Human Services prevention targetsor a customized prevention target so that limited prevention resources can be used most effectively. This strategy can be tailored to specific HAI reduction goals and healthcare settings.


The API key must be passed as a header value assigned to the x-api-key property. Patient Health Questionnaire-9 – Nine-item self-report tool to assess depressed mood in the past 2 weeks. TAP Prevention Prioritization Toolkit – May 2019 [PDF – 22 pages] – Compilation of templates to help facilities prioritize infection prevention gaps and develop strategies to implement corresponding interventions. All TAP Facility Assessment Tools are also available in SurveyMonkey and REDCap templates. To compile and summarize Assessment responses, CDC has developed TAP Excel Spreadsheets to create accompanying TAP Feedback Reports. The American Council on Science and Health is a research and education organization operating under Section 501 of the Internal Revenue Code.

Dr. Subramaniam’s participation in this publication arises from her role as a project scientist on a cooperative agreement for this study. Dr. Marsden has received educational grant funding at King’s College London for a study of psychological interventions in opioid agonist treatment (2010–2016; Indivior PLC via Action on Addiction). Merck Serono has given him honoraria in 2013 and 2015 for clinical eco sober house review oncology medicine). He has received honoraria from Indivior via PCM Scientific in relation to the Improving Outcomes in Treatment of Opioid Dependence conference (faculty member, 2012–2013; co-chair, 2015–2016). Additionally, the CDI Deep Dive for Infection Preventionists is designed to accompany the CDI TAP Facility Assessment Tool and be completed once per facility by the infection preventionist .

  • McNeely J, Cleland CM, Strauss SM, Palamar JJ, Rotrosen J, Saitz R. Validation of self-administered single-item screening questions for unhealthy alcohol and drug use in primary care patients.
  • Clinics adopting electronic screening should be prepared to offer assistance to some patients, particularly those who are older or less educated, and should have the capacity to use an interviewer-administered approach when required.
  • Participants completed the TAPS tool in self- and interviewer-administered formats, in random order.

The TAPS-1 is the screening component of the TAPS tool, and consists of a single stem question with four items covering frequency of past-12-month use of tobacco, alcohol, and illicit drugs, and non-medical use of prescription medications (Fig. ​ (Fig.1). Participants completed the TAPS tool in self- and interviewer-administered formats, in random order. In this secondary analysis, the TAPS-1 was evaluated against DSM-5 substance use disorder criteria to determine optimal cut-points for identifying unhealthy substance use at three severity levels (problem use, mild SUD, and moderate-to-severe SUD). eco sober house cost The myTAPS Tool would be feasible in most primary care clinical settings, and was well accepted by patients in this large and diverse sample of adult primary care patients. However, primary care practices that choose this format should be prepared to offer assistance to some patients, particularly those who are older or have less than a high school level of education, and should have the capacity to screen using an interviewer-administered approach when required. Future studies should assess the acceptability and the feasibility of myTAPS screening when it is implemented in routine practice.

DSM-5 SUD criteria were determined via the modified Composite International Diagnostic Interview. The dependencies are based on the id of the parent question or questions and how they were answered. 0, that means that if the question with the id of had an answer that was not 0, this question should be displayed.

Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool

Other entities (e.g., QIN-QIOs, HIINs, Health Departments, hospital associations) that have access to NHSN data through NHSN’s “Group” function may also generate TAP Reports for the healthcare facilities within their groups/states. Publically available data from NHSN (e.g., CMS Hospital Compare) may also be used to rank facilities according to their CAD. Prevention partners engaged in quality improvement and collaborative work may use the TAP Strategy to identify and reach out to facilities within their jurisdictions to assist them with prioritizing their HAI prevention efforts. In this way, groups and facilities can use data for action to target gaps for prevention and intervention.

Participants with lower education, as well as those over 65 years old, more frequently requested assistance and required more time to complete myTAPS screening. Prior studies have similarly shown that electronic and self-administered questionnaires may be more difficult for primary care patients having less computer familiarity or lower literacy . Given that most patients would be able to complete the myTAPS on their own, adoption of a predominantly electronic screening approach may free up the time for clinical staff to help those patients who need it. Both self- and interviewer-administered formats were able to detect unhealthy substance use at various severity thresholds, with test performance falling in the acceptable to excellent range. A noteworthy difference between the two formats is that disclosure rates for prescription medication misuse were 50% higher with the self-administered format.

Review the latest science on screening for substance use and read about how a variety of clinicians have integrated screening into their practice settings, including which tools they use and useful considerations to get started. Data used for the TAP Reports are reported by healthcare facilities to CDC’s National Healthcare Safety Network . Healthcare facilities may use their own data to generate TAP Reports for different HAIs and patient care locations.

Performance of the TAPS-1

Opioid overdose has reached epidemic levels in the United States,16 , 17 and primary care clinicians are uniquely suited to identify opioid risks and prevent overdose death. The TAPS tool is a brief, two-part assessment of substance use and misuse in primary care patients that can be self-administered or administered through clinician interview. The Screening and Assessment Tools Chart provides a comprehensive guide and links to evidence-based screening and assessment tools you can use with your patients from adolescence to adulthood. It is organized by substance type, patient age, and administration method to help you find the right tool for your practice. The TAPS-1 can identify unhealthy substance use in primary care patients with a high level of accuracy, and may have utility in primary care for rapid triage. The statistics suggest that substance use may be a missed diagnosis in cases across the country, and possibly point to the need for more comprehensive, routine, and effective screening of patients, young and older when they present for medical care.

Overall, myTAPS screening was feasible and well accepted by adult primary care patients. Clinics adopting electronic screening should be prepared to offer assistance to some patients, particularly those who are older or less educated, and should have the capacity to use an interviewer-administered approach when required. The Tobacco, Alcohol, Prescription Medication, and Other Substance use tool is a combined two-part screening and brief assessment developed for adult primary care patients.

NIDA Screening Tools API Gateway

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. The datasets used and/or analysed during the current study are available from the corresponding author or from the NIDA Center for the Clinical Trials Network on reasonable request.

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