Reliability and validity of the Treatment Outcome Profile among patients attending methadone maintenance treatment programs in Kunming, China.

BACKGROUND & OBJECTIVE: Substance misuse has been a major health and social issue worldwide and has become an important public health issue in China over the past two decades. Methadone maintenance treatment (MMT) has been proved worldwide by large bodies of research to be one of the most effective practices for illicit drug users. The Treatment Outcome Profile (TOP) was developed in 2007 by the UK National Treatment Agency (NTA). It has been proved to be a reliable instrument for outcome measure. This study aim to develop the Chinese version of the Treatment Outcome Profile (TOP), and to assess whether TOP is a reliable outcome measure that can be recommended for use in Chinese MMT program.

METHODS: The Chinese version of TOP was translated and revised based on the English version of TOP. Psychometric properties of TOP were evaluated through face-to-face interviews in 197 patients who had been attending methadone maintenance treatment clinics in Kunming city, Yunnan Institute for Drug Abuse, for less than three months. Patients were interviewed by 3 trained interviewers. Reliability and validity of the instrument were analyzed by measures including test-retest and inter-rater reliability, concurrent validity and change sensitivity. Concurrent validity was assessed by comparing the scores from TOP with scores obtained from validated clinometric instruments. Self-reported opiate use was compared with results of urine analysis. Change sensitivity was judged by t-tests and chi-square tests.

RESULTS & CONCLUSIONS: About 67% of the 197 interviewers were male and 33% were female. Test-retest reliability of TOP scores (after 10 days interval) were good (K=0.65 to 0.95), inter-rater correlations (ICC) ranged from 0.7 to 0.9, and the criterion validity ranged from 0.72 to 0.88. TOP covers a large scope of problems encountered by drug users needed for treatment. The Chinese version of TOP is a reliable and valid assessment tool.