Obtaining preference scores for an abbreviated self-completion version of the Teen-Addiction Severity Index (ASC T-ASI) to value therapy outcomes of systemic family interventions: a discrete choice experiment

• Published in: The European journal of health economics Vol. 25; no. 5; pp. 903 - 913
• Main Authors: Schawo, Saskia, Hoefman, Renske, Reckers-Droog, Vivian, Lawerman-van de Wetering, Liesbet, Kaminer, Yifrah, Brouwer, Werner, Hakkaart-van Roijen, Leona
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2024; Springer Nature B.V
• Subjects: Addictions; Adolescent; Adolescents; Adult; Behavior, Addictive - psychology; Behavior, Addictive - therapy; Choice Behavior; Clinical outcomes; Delinquency; Drug use; Economic Policy; Economics; Family Therapy - methods; Female; Health Care Management; Health Economics; Humans; Intervention; Juvenile Delinquency - psychology; Male; Medicine; Medicine & Public Health; Mental health; Middle Aged; Netherlands; Original Paper; Pharmacoeconomics and Health Outcomes; Pilot Projects; Preferences; Public Finance; Public Health; Quality of Life; Severity of Illness Index; Substance use; Substance use disorder; Substance-Related Disorders - therapy; Surveys and Questionnaires; Tariffs; Teenagers; Young Adult; Netherlands; Preference-based measure; H51; Delinquency; Mental health; C25; H53; Substance abuse; Preference scores; I19; Discrete choice experiment; I18; Adolescent; Economic evaluation
• ISSN: 1618-7598; 1618-7601; 1618-7601
• DOI: 10.1007/s10198-023-01633-3

Background Systemic family interventions for adolescents with problems of substance use and/or delinquency are increasingly focused subject of economic evaluations. Treatment effects go beyond improvements in commonly measured health-related quality of life (HRQOL). The Teen-Addiction Severity Index (T-ASI) was identified as capable of capturing these broad outcomes. However, it lacks preference-based scores. An abbreviated self-completion version (ASC T-ASI) was created and validated, covering the T-ASI domains substance use, school, work, family, social relationships, justice, and mental health. This study aimed to obtain societal preference scores for the ASC T-ASI. Methods Preferences were elicited in a sample of the Dutch general adult population ( n  = 1500), using a web-based Discrete Choice Experiment. Choice tasks included two unlabeled alternatives with attributes and levels corresponding to the domains and levels of the ASC T-ASI. A pilot study ( n  = 106) informed priors, optimal presentation, and number of choice tasks applied in the main study. Data were analyzed using a mixed multinomial logit model. Results Preference scores were logically ordered, with lower scores for worse ASC T-ASI states. Scores were most influenced by reductions in problems concerning the domains substance use, mental health, justice, and family. Tariffs were calculated for each ASC T-ASI state, ranging from 0 (worst situation) to 1 (best situation). Conclusions The tariffs enable preference-based assessments of the broad effects of systemic family interventions for adolescents with problems of substance use and/or delinquency. The outcome reflects addiction-related rather than health-related utility and can be used next to generic HRQOL instruments in relevant economic evaluations. Given the source used for the preferences, interpretations and valuation of scores require attention.