How Data on Outcomes Can Improve Addiction Treatment

By The Fix staff 02/26/18

"If you’re able to find out the outcomes, if you can see specific data in black and white, that lets you make a more informed decision about whether you want to attend that program."

People looking at data

If you're seeking treatment for a life-threatening, degenerative disease, you're going to want to know that you're accessing the best treatment possible. Unfortunately, while it's common to track outcomes for physical illnesses like diabetes or cancer, tracking outcomes for people treated for substance use disorder and other behavioral health issues is much less common.

"Outcomes measurement isn’t standard in addiction treatment and behavioral health because behavioral health providers have not been held to the same standards as people who are doing acute care (for physical illnesses)," says Audrey Klein, the exec director of the Butler Center for Research at the Hazelden Betty Ford Foundation.

The Hazelden Betty Ford Foundation has been at the forefront of tracking patient outcomes for decades. The Butler Center employs full-time staff who are responsible for collecting information on previous patients at one, three, six, nine and twelve months after they leave their treatment program.

The outcomes data usually focuses on two core questions: Has the patient stayed abstinent since leaving treatment? And if not, for how many days did they actually use substances.

"We look at those two measurements over time and always try to improve them," Klein says. "Over time we have implemented a number of things to improve those outcomes."

One program that emerged as a way to improve outcomes was the My Ongoing Recovery Experience (MORE) program, which gives Hazelden Betty Ford patients access to web-based recovery support after they have left treatment.

When the program started in 2006, research from the Butler Center immediately showed that it was making a big difference for patients.

"Research on outcomes has shown that patients who use MORE after treatment have much higher abstinence rates than people who don't," Klein says.

More recently, the Hazelden Betty Ford Foundation has introduced the COR-12 program, which offers medication-assisted treatment for opioid addiction in conjunction with Twelve Step philosophies. The Butler Center just completed a study of over 250 patients to see whether and how outcomes improve for people who participate in the COR-12 program.

Klein is careful to point out that merely tracking outcomes does not improve the quality of treatment: rather, how that data is used to inform clinical practice is what is important. She says that the Hazelden Betty Ford Foundation's focus on continuously collecting and evaluating data helps clinical staff know what is working best, even when it comes to small everyday details.

"MORE and COR-12 are at the level of specific programs that we have created and made available over time. Those are larger projects, but it's important for me to point out that day-to-day we are always sharing our outcomes data to make therapy better, and to improve our clinical practice at the level of our patients and care providers."

Those constant improvements are why the Hazelden Betty Ford Foundation emphasizes the importance of tracking outcomes.

"We are constantly having clinicians look at outcomes, making adjustments to care, and introducing new evidence-based practices. In those scenarios, outcomes are a necessary step to improve clinical care," Klein says.

For most people, an ideal outcome after treatment for substance use disorder is abstinence. However, since addiction is by nature a chronic disease often accompanied by relapse, it’s not realistic to expect 100 percent of patients to report abstinence, Klein says. However, about 70 percent of patients at the Hazelden Betty Ford Foundation are abstinent in the nine months following treatment.

"That’s really high," Klein says, pointing out that clinical research studies of people who have completed treatment generally find a much higher rate of relapse. "With a huge caveat thrown in that we're not able to compare apples and oranges, you can get a sense of outcomes when you look at published research. When you look at the Hazelden Betty Ford Foundation outcomes they tend to be higher than what is found in other studies."

Klein says that she would like to see more treatment centers tracking outcomes and releasing the data so that competitors and consumers can have a better idea of what is common in the industry. However, she also notes that tracking data can be time consuming and expensive. Still, as more healthcare organizations and insurance payers demand outcomes data, she expects to see the collection of outcomes data for addiction and other behavioral health issues improve.

Accessing that data can help patients and their families chose the treatment center that will best serve them.

"It really puts them in the position of being a more informed customer," Klein says.

Recently, she received an email from a woman asking about outcomes data. She wanted the information in order to choose the treatment center that would be best for her.

"If you’re able to find out the outcomes, if you can see specific data in black and white, that lets you make a more informed decision about whether you want to attend that program," Klein says.

Get more information on the Hazelden Betty Ford Foundation here, and connect with the organization on Facebook and Twitter.

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