Citation

Glass JE, Ilgen MA, Winters JJ, Murray RL, Perron BE, Chermack ST. J. Psychoactive Drugs 2010; 42(3): 315-325.

Affiliation

George Warren Brown School of Social Work, Washington University, St. Louis, Missouri, USA. jglass@gwbmail.wustl.edu

Copyright

(Copyright © 2010, Haight-Ashbury Publications in association with the Haight-Ashbury Free Medical Clinic)

DOI

unavailable

PMID

21053754

PMCID

PMC3071023

Abstract

This study attempts to validate substance use disorder (SUD) treatment performance measures (PM) in a naturalistic treatment setting. Despite its significance in healthcare systems and in SUD populations, suicidality is one patient characteristic that remains unexplored in the context of SUD PMs. The current study focused on the extent to which the care processes encouraged by SUD PMs were associated with improved outcomes in patients with a prior suicide attempt as compared to those without. We abstracted Addiction Severity Index and health services data from the VA medical record for 381 veterans who initiated outpatient SUD treatment and completed baseline intake measures at a Midwestern VA hospital. Cox proportional hazard regressions examined how baseline characteristics, prior suicide attempts, and PM status predicted the time until hospitalization for psychiatric or substance use problems. Prior suicide attempts significantly interacted with treatment engagement, and hospitalization risk was significantly higher among individuals with a prior suicide attempt who did not meet PMs. This study provides initial observational evidence that past suicide attempts may be a factor that should be considered when defining performance standards that influence the processes of SUD treatment. Future research on PMs should take into account the differences on indicators of high risk and poor treatment outcomes.

Language: en