Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST

Area of Science:

• Primary Care Medicine
• Substance Use Disorders
• Screening Instruments

Background:

• Primary care settings require efficient tools to identify patients with substance use problems.
• Existing screening methods can be lengthy, necessitating brief assessment instruments.

Purpose of the Study:

• To evaluate the performance of the TAPS (Tool for Addiction Prevention and Screening) Tool.
• To compare the TAPS Tool's accuracy against the WHO ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) for identifying substance use risk.

Main Methods:

• A two-step screening approach using the TAPS Tool followed by the WHO ASSIST was administered to 2000 adult primary care patients.
• Sensitivity and specificity analyses were conducted to assess the TAPS Tool's ability to identify moderate- and high-risk substance use as defined by the WHO ASSIST.

Main Results:

• The TAPS Tool demonstrated acceptable to excellent sensitivity and specificity for identifying high-risk tobacco and alcohol use, and high-risk illicit drug use.
• Good sensitivity and specificity were observed for moderate-risk tobacco and alcohol use.
• While sensitive for moderate-risk marijuana use, the TAPS Tool showed lower sensitivity for other illicit drugs and non-medical prescription medication use, though specificities remained high.

Conclusions:

• The TAPS Tool is effective in identifying adult primary care patients with high-risk substance use across various categories.
• It accurately identifies moderate-risk users of tobacco, alcohol, and marijuana.
• The TAPS Tool's brevity and focus on recent substance use (past 3 months) offer advantages over the WHO ASSIST for primary care screening.