Genome Stability in Embryonic Stem Cells

Abstract

Introduction: Research has identified several patient mechanisms of behavioral change that improve during alcohol use disorder treatment and support longer-term recovery. Yet, few existing measurement-based care (MBC) tools exist to help addiction treatment clinicians routinelymeasure, track, and evaluate changes in thesemechanisms, hindering the use of treatment progress data to inform treatment decision-making (Hallgren, Wilson, & Witkiewitz, in press). Digital technologies can support the implementation of MBC (Hallgren, Bauer, & Atkins, 2017), and designing MBC technologies that address the preferences, priorities, and workflows of clinicians is critical to improving the eventual penetration of MBC in frontline practice. Method: In the present study, we sought to understand frontline addiction treatment clinicians' perspectives and desires around using measurement-based care (MBC) technologies. Semi-structured interviews were held with eight clinicians in a publicly-funded outpatient addiction treatment clinic. Clinicians were asked about their typical workflows, clinical approaches, treatment targets, use of existing digital technologies, and foreseeable pros and cons of MBC technologies. Clinicians also completed a card-sorting task in which they rated the usefulness of tracking various addiction-related mechanism and outcome variables. Results: During interviews, clinicians described several potential benefits of MBC (e.g., improving clinician-patient communication, helping patientsmore easily realize their clinical improvements), potential limitations of MBC (e.g., increased clinician workloads, some clinical targets not being measurable via patient self-report), desires for MBC technologies (e.g., tracking treatment goals alongside clinical outcomes, emphasizing intrapersonal and interpersonal growth in addition to symptom reduction), and limitations of existing workflows and technologies (e.g., limited clinical utility of existing electronic health record systems and current processes for tracking patient goals). In the card sort, clinicians rated several mechanism and outcome variables as being "very helpful" to routinely track, especially patient coping skills, social support for recovery, motivation for abstinence, and engagement in valued activities. Conclusion: Incorporating addiction treatment clinicians' perspectives and desires into the design of MBC technology may improve such technology's perceived usefulness and usability, potentially leading to better implementation of MBC. Such technologies should be designed to facilitate communication, maximize patient understanding of progress, minimize burden to clinicians,measure patient growth and reduction in clinical symptoms, and track patient-reported goals in tandemwith treatment progress.