Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool
Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool
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DOI：
10.1186/s13722-019-0167-z
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发表时间：
2019-10-15
影响因子：
3.7
通讯作者：
McNeely, Jennifer
中科院分区：
文献类型：
--
作者：
Adam, Angeline;Schwartz, Robert P.;McNeely, Jennifer
背景TAPS工具是一种物质使用筛查和简要评估工具，是为初级保健医疗环境中使用而开发的。它是对包括非法和处方阿片类药物在内的所有常用物质类别提供快速评估的首批筛查工具之一，也是仅有的以电子自我给药格式(MyTAPS)设计和验证的筛查工具之一。对TAPS工具验证研究数据的二次分析描述了myTAPS在初级保健患者中的可行性和可接受性。方法来自5个初级保健诊所的成人患者(N=2000)在平板电脑(MyTAPS)上完成TAPPS工具，并以面试者管理的形式进行。跟踪了援助请求和所需时间，参与者完成了关于易用性、音频指导使用情况和格式偏好的调查。Logistic回归被用来检查确定的亚群的结果，包括完成电子筛查可能有更大困难的组，以及那些可能更喜欢电子自我管理方法的组。结果几乎所有参与者(98.3%)都表示myTAPS使用方便。完成myTAPS筛查的中位时间为4.0min(平均4.48，标准差2.57)。年龄较大、西班牙裔、黑人或报告使用非医疗处方药的参与者需要更多时间，而女性需要更少时间。25%的参与者请求帮助，而受教育程度较低(OR=2.08，95%CI 1.62-2.67)或年龄65岁(OR=2.79，95%CI 1.98-3.93)的人请求帮助的频率更高。听力指导的使用率为18.3%，使用频率较高的为低学历(OR=2.01，95%CI为1.54~2.63)、65岁(OR=1.79，95%CI为1.22~2.61)、黑人(OR=1.30，95%CI为1.01~1.68)。女性(OR=1.29，95%CI为1.00~1.66)和吸毒者(OR=1.43，95%CI为1.09~1.88)更喜欢myTAPS，而文化程度较低的被调查者更喜欢面试者管理的形式(OR=2.75，95%CI为2.00~3.78)。结论总体而言，MyTAPS筛查是可行的，并为成人初级保健患者所接受。采用电子筛查的诊所应该准备好向一些患者提供帮助，特别是那些年龄较大或受教育程度较低的患者，并且应该有能力在需要时使用面试者管理的方法。
Background The TAPS Tool is a substance use screening and brief assessment instrument that was developed for use in primary care medical settings. It is one of the first screening instruments to provide rapid assessment of all commonly used substance classes, including illicit and prescription opioids, and is one of the only available screeners designed and validated in an electronic self-administered format (myTAPS). This secondary analysis of data from the TAPS Tool validation study describes the feasibility and acceptability of the myTAPS among primary care patients. Methods Adult patients (N = 2000) from five primary care clinics completed the TAPS Tool on a tablet computer (myTAPS), and in an interviewer-administered format. Requests for assistance and time required were tracked, and participants completed a survey on ease of use, utilization of audio guidance, and format preference. Logistic regression was used to examine outcomes in defined subpopulations, including groups that may have greater difficulty completing an electronic screener, and those that may prefer an electronic self-administered approach. Results Almost all participants (98.3%) reported that the myTAPS was easy to use. The median time to complete myTAPS screening was 4.0 min (mean 4.48, standard deviation 2.57). More time was required by participants who were older, Hispanic, Black, or reported non-medical prescription drug use, while less time was required by women. Assistance was requested by 25% of participants, and was more frequently requested by those who with lower education (OR = 2.08, 95% CI 1.62-2.67) or age > 65 years (OR = 2.79, 95% CI 1.98-3.93). Audio guidance was utilized by 18.3%, and was more frequently utilized by participants with lower education (OR = 2.01, 95% CI 1.54-2.63), age > 65 years (OR = 1.79, 95% CI 1.22-2.61), or Black race (OR = 1.30, 95% 1.01-1.68). The myTAPS format was preferred by women (OR = 1.29, 95% CI 1.00-1.66) and individuals with drug use (OR = 1.43, 95% CI 1.09-1.88), while participants with lower education preferred the interviewer-administered format (OR = 2.75, 95% CI 2.00-3.78). Conclusions 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.