Reshaping Recovery Services
Therapeutic Solutions (Addictions) worked with our partners Illy Systems and CGL to support Northamptonshire County Council in understanding the nature of service delivery over two time periods (2011 and 2014). This study incorporated two main components to understand the case-mix of clients accessing treatment services in Northamptonshire:
- The first builds on recommendations within the Medications in Recovery: Re-Orientating Drug Dependence Treatment report to undertake a clinical audit of practice. An audit was undertaken based on a random sample of over 300 case records held on Illy System’s Care-Path Management Information system. This is a representative sample of individuals known to treatment at 95% confidence and 5% margin of error. This study was compared to a baseline audit (n=121) undertaken in 2011-12.
- The audit was supplemented by development of two multivariate models of Northamptonshire DAAT records as held on the National Drug Treatment Monitoring System (NDTMS) using an array of explanatory variables including socio-demographic context (age, ethnicity, gender); home location; treatment duration and type of intervention received and drug or alcohol-using profiles. An initial bivariate test was undertaken prior to developing the models to avoid the concept of statistical ‘over-fitting’. The first model examined the factors that predicted a ‘successful treatment’ outcome as defined by NDTMS and the second specifically examined correlates to disengagement (drop-out).
The study identified a range of enhancements that needed to be made across a range of service provision including the links between criminal justice and community-based services.
Developing Assessments to Improve Recovery
In Northamptonshire we have worked with CGL and the County Council to implement use of the Addiction Dimensions for Assessment and Personalised Treatment (ADAPT) assessment tool (Marsden et al, 2014) across local services. The aim of this project is to identify factors that predict abstinence from Class A drugs among opiate users in treatment in one English local authority area. In addition to staff interviews, we undertook detailed analysis of 776 opiate users in treatment were using the ADAPT tool. Our analysis encompasses three domains and 14 subdomains covering addiction severity, recovery strengths and coexisting health and social needs. These data were matched to information held on the National Drug Treatment Monitoring System (NDTMS) including outcome measures via the Treatment Outcome Profile (TOP). We created models to predict predict whether individuals in treatment were abstinent or still using Class A drugs concurrently. The study will provide CGL with the opportunity to develop interventions personalised to the individual’s recovery needs.