Integrated Care for drug users: Principles and practice: page 27

Integrated Care for drug users: Principles and practice

SMR24

Background The SMR24 monitoring form was one of the most commonly identified assessment tools from the questionnaire survey, however it is not designed to be used as an 'assessment tool'. The SMR24 is the data collection tool for the Scottish Drug Misuse Database, which offers a profile of drug misuse in Scotland based on anonymous information on new problem drug misusers in contact with services. Established in 1990 at ISD Scotland on behalf of the Scottish Executive, the Database gathers information from most specialist drug services in Scotland and from a number of general practitioners, providing a unique source of information on drug misuse in Scotland. Statistics from the Database are published in the annual Drug Misuse Statistics Scotland publication, available via the Drug Misuse In Scotland website at: http://www.drugmisuse.isdscotland.org/index.shtml The information presented on the SMR24 form relates to new patients/clients. As such, the statistics do not reflect the total number of drug misusers seen by services during any period. The SMR24 form has been in use since April 2001. Prior to that date there were two forms in use: the SMR22 for prescribing services and SMR23 for non-prescribing services. For further information on providing information to the Scottish Drug Misuse Database, contact ISD Scotland at: http://www.drugmisuse.isdscotland.org/sdmd/sdmd.htm
Where did you find out about this tool	Commissioners of Service 42% National tool 25% Conference / Seminar 8.3% Developed In-house 8.3%
How long have you used this tool	Mean 16.6 Months Standard Deviation 18.1
Origin	Original Format 75% Developed for agency's use 16.6% Developed as joint tool with other agencies 8.3%
Comparative Information	Published Research Literature	Survey Results (n=12)
Application
Primary Use	Audit: It offers a profile of drug misuse in Scotland, based on anonymous information on 'new' problem drug users in contact with services.	Assessment 66.7% Research 25% Evaluation 16.6% Screening 8.3% Audit 8.3%
Secondary Use	Research	Audit 50% Evaluation 33.3% Screening 33.3% Assessment 25% Research 16.6%
Client Groups	All - although for the purpose of compilation of reports, excludes penal establishments inmates, to improve validity of comparisons between areas (as limited coverage)	Adult 100% Women 83% Adolescent 75% Ethnic Groups 75% Prisoners 66.7%
How often is this tool completed with each client	Initial contact, or if it has been at least 6 months since last attendance at the service.	Initial Contact 66.7% 6 Monthly 16.6% 3 Monthly 8.3% Initially & 6 Mthly 8.3%
Administrative Issues
Guidelines/Manual required	Yes, there is a detailed manual and service providers have a copy.	Yes 66.7% No 25% No Information 8.3%
Approximate time to complete	No information	Mean 22 minutes Standard Deviation 16.8
Time to score	Not applicable	Mean 15 minutes Standard Deviation N/A
Scoring by	No scoring	N/A
Validity: No studies undertaken
Training requirements	Less than, or equal to, one day. Training was provided in conjunction with introduction of the new SMR24 form.	Mean 0.75 day
Users Opinion & Comment
Positive features	Relative Score 60.4% Quick to complete Good evaluation data Tick boxes make information easy to record Can be used for all clients
Concerns	Relative Score 16.7% Tick boxes do not allow individual responses to questions Format of date collection does not easily lead itself to audit or evaluation Does not record the clients views / opinions

Development of Core Data Sets

Sources of Information

In order to construct an initial Personal Information and Assessed Need core data set, four existing data sets were examined:

SSA Personal Information core data set (Elderly services)
SMR24 form
Christo G., "Common data set", Druglink May/June 2001
Forth Valley Substance Action Team core data set (Draft)

Using the SSA core data set as a template, the four sets were integrated to produce a 21-item draft Personal Information core data set and the Assessed Need core data set.

Comparison with existing Assessment tools

Through the initial mapping exercise, 26 assessment tools were returned by drug services with the questionnaires.

One of these tools, the SMR24, has already been used to construct the draft core data sets. The remaining 25 tools were used to measure the extent to which the draft core data sets matched with the information currently collected by drug services.

A record was made of how often the items in the two draft data sets appeared in the 25 assessment tools.

KEY FINDINGS:

Comparison of Assessment tools

Two of the 21 data items (name and date of birth) in the Personal Information core data set, were found in over 75% of the 25 Assessment tools studied.
Four items appeared in 50-75% of tools, 9 items in 25-50% and 6 in less than 25% of the 25 Assessment tools studied.
7 of the 12 sub-headings identified in the Assessed Need core data set, appeared as either sub-headings or data items in one or more or the 25 Assessment tools studied
One (Employment) of the 82 data items in the Assessed Need core data set were found in over 75% of the Assessment tools studied.
Four items appeared in 50-75% of tools, 11 items in 25-50% and 47 in less than 25% of the 25 Assessment tools studied.

19 of the core data items in the Assessed Need core data set did not feature in any of the 25 Assessment tools studied.

The following core data sets were developed in collaboration with the Joint Future Unit drawing on the information gained from this study. These data sets should be used as a basis for the development of single shared assessment protocols and documentation for people with drug problems.

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