Scoping review of the characteristics and implementation of routine outcome monitoring and feedback for adults and young people accessing alcohol and other drug use treatment.

BACKGROUND

Routinely monitoring therapeutic processes and outcomes is central to evidence-based Alcohol and Other Drug (AOD) use treatment. However, it remains unclear how this routinely captured data is 'fed back' to AOD clinicians and clients and used to inform treatment.

OBJECTIVES

This scoping review examined evaluations of routine outcome monitoring and feedback in young people and adults accessing AOD treatment to describe: a) the nature and extent of evidence; b) the development, characteristics and use of feedback and c) implementation considerations.

METHODS

A systematic search of 11 online databases produced 796 articles. Independent title/abstract and full-text screening identified 20 evaluations for inclusion. Data extraction was performed independently by two researchers.

RESULTS

Evaluations were primarily conducted in the USA (11/20), using non-randomised designs (14/20). Understanding of feedback is complicated by heterogeneity and missing information, but commonalities included technology-assisted outcome assessment to generate immediate, weekly, multi-dimensional feedback comprising a visual representation of change across time. Explicit guidance for using feedback in AOD treatment was rare (1/20). Implementation considerations are discussed across a) fidelity and training practices, b) participant and provider experience and c) barriers and enablers.

DISCUSSION AND

CONCLUSIONS

Efforts to examine how best to generate, present and use feedback to inform AOD treatment are needed. Optimising the use of feedback across treatment settings will require examination of the interplay between feedback characteristics and clinician, client and contextual variables. Improved attention to idiographic outcomes, benchmarks, diversity considerations, health literacy, treatment context, training, fidelity and the reporting of evaluations are warranted.