Background

When treating patients with alcohol use disorder (AUD), best practice guidelines recommend the use of standardised assessment instruments to obtain reliable information about psychological symptoms and functioning to inform treatment. Due to time constraints and administrative burden, many mental health practitioners do not routinely use standardised assessments. To overcome these barriers, an instant assessment and feedback system (iAx) was developed that electronically administers standardised instruments. Responses are instantly scored and benchmarked against clinical norms for immediate interpretation. This allows for timely assessment and feedback. The aim of this study was to evaluate the implementation of the iAx system at a specialist alcohol and drug outpatient unit in a public hospital.

Methods

Baseline (pre-iAx implementation; paper-and-pencil assessments) and follow-up (post-iAx implementation) clinical audits collated records from 313 patients with AUD across 2,616 treatment sessions. Multilevel modelling was used to determine if use of standardised instruments increased post-iAx implementation.

Results

Post-iAx implementation, there was a significant increase in the probability of using standardised assessments during the initial assessment and throughout treatment (ps < 0.001). Specifically, the use of standardised assessments to inform initial assessment of patients increased from 51% to 89%, and progress monitoring of symptoms increased from 28% to 84%. A significant increase in treatment completion rates was also observed post-iAx implementation (from 15.6% to 32.4%). Psychologists and patients also provided feedback on iAx acceptability, appropriateness and feasibility.

Conclusions

This study found support for the successful implementation of an electronic, theory-driven iAx system to improve assessment practices with patients with AUD in routine clinical settings.

中文翻译：

---

改善酒精使用障碍的评估和进展监测：即时评估和个性化反馈系统 (iAx) 的实施评估

背景

在治疗患有酒精使用障碍 (AUD) 的患者时，最佳实践指南建议使用标准化评估工具来获取有关心理症状和功能的可靠信息，从而为治疗提供信息。由于时间限制和行政负担，许多心理健康从业者并不经常使用标准化评估。为了克服这些障碍，开发了一个即时评估和反馈系统 (iAx)，以电子方式管理标准化仪器。立即对反应进行评分，并根据临床规范进行基准测试，以便立即解释。这允许及时评估和反馈。本研究的目的是评估 iAx 系统在公立医院酒精和药物专科门诊部的实施情况。

方法

基线（iAx 实施前；纸笔评估）和后续（iAx 实施后）临床审计整理了 2,616 次治疗期间 313 名 AUD 患者的记录。多级建模用于确定标准化仪器的使用是否增加了 post-iAx 实施。

结果

iAx 实施后，在初始评估和整个治疗过程中使用标准化评估的可能性显着增加 (ps < 0.001)。具体而言，使用标准化评估为患者的初步评估提供信息的比例从 51% 增加到 89%，症状进展监测从 28% 增加到 84%。在实施 iAx 后还观察到治疗完成率显着提高（从 15.6% 到 32.4%）。心理学家和患者还就 iAx 的可接受性、适当性和可行性提供了反馈。

结论

这项研究发现支持成功实施电子的、理论驱动的 iAx 系统，以改进常规临床环境中 AUD 患者的评估实践。