Quality Measures Database

Keywords

Domains

Process
	Acceptability
	Accessibility
	Appropriateness
	Competence
	Continuity
	Effectiveness
	Efficiency
	Safety
	Comprehensiveness
	Patient-Centeredness
	Legal

Outcome
	Health Conditions
	Human Function
	Well-Being
	Deaths
	Service Outputs
	Satisfaction
	Impact on Society

Structure
	Physical Infrastructure
	Personnel Management
	Information Management
	Financial Management
	Quality and Safety

Non-Medical Determinants of Health
	Health Behaviors
	Living and Working Conditions
	Personal Resources
	Environmental Factors
	Health Literacy

Equity
	Equity

Specific Conditions
	Comorbid Conditions
	Chronic Conditions
	Acute Conditions
	Substance Abuse
	Anxiety Disorders
	Somatoform Disorders
	Sleep Disorders
	Eating Disorders
	Personality Disorders
	Mood Disorders
	Psychosis
	Impulse Control Disorders
	Elderly
	Reproductive Mental Health Disorders

Special Groups
	Ethnic / Cultural Minorities
	People Who Live in Rural Areas
	People with a Family History of a Mental Health Condition
	Social Service Welfare Recipients
	Homeless or Itinerant
	Unemployed
	Aboriginal
	Seniors in Facilities
	Recent Refugees
	Immigrants
	Residents of Correctional Institutions
	Inner City Residents
	Speakers of English as a Second Language

Age Groups
	Elderly
	Adult
	Youth
	Children
	Children

Gender Groups
	Women
	Men
	Gender Identities Other Than Men or Women

Interventions
	Medication
	Psychotherapy
	Peer Support
	Prevention
	Other Somatic Treatments
	Early Detection
	Health Promotion
	Family Involvement
	Group Treatment
	Self-Management Support
	Rehabilitation
	Physical Health Intervention

Clinical Setting
	Shared Care
	Emergency Services
	School-based Mental Health Services
	Work-based Mental Health Services
	Outreach Services
	Solo Practitioner
	Group Family Practitioner
	Community Health Care Centre
	Walk in Clinics

Level of Evidence

	I	Consistently higher quality studies specifically focused on primary mental health care.
	II	Less rigorous studies specifically focused on primary mental health care or extrapolated from higher quality studies from secondary mental health care.
	III	Preliminary research evidence only or evidence based on consensus opinion only.
	IV	Evidence based on individual expert opinion.
	V	Validated scale: Research has been conducted to determine it has at least some properties associated with a high quality scale
	VI	Non-validated scale: Research regarding the quality of the scale has not been conducted.

Measure Ranking

From To

Detailed Results

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Screening Tool for Substance Problems

Overall Rank: 63

Use of a common, validated screening tool (e.g., a four-item test with questions on Cutting down, Annoyance at criticism, Guilty feelings and use of Eye-openers (CAGE), The Alcohol Use Disorders Identification Test (AUDIT)) for alcohol or other drug problems for all new patients.

Domain : Early Detection

Diagnosis and initiation of treatment at very early stages of the disease, when little or minimum intervention can bring therapeutic results (e.g., within the first two years of illness).
Additional Domain(s) : Patients with Comorbid Conditions, Accessibility

Rationale

The medical literature does not support definitive statements about the best way(s) to treat patients who are diagnosed with both major depression and substance abuse/dependence. The majority of studies reviewed indicate that success in treating dependency on alcohol, cocaine, and other abused substances is more likely if accompanying depression is addressed. There is some evidence that patients with major depression which is secondary to their substance abuse may have remission if their depressed mood once the substance abuse is treated. However, it is difficult to separate secondary depression from primary depression that predates or is separate from the substance use.

The CAGE questions are sensitive and specific for diagnosing alcoholism. One positive response has a sensitivity if 85% and a specificity of 89%, and two positive responses has a specificity of 96%.

Primary Reference

Major Depression in Adults in Primary Care. May 2004, Institute for Clinical Systems Improvement. P: 12 Retrieved on Aug 3, 2006 From:http://www.icsi.org/knowledge/detail.asp?catID=29&itemID=180

Level of Evidence

III: Preliminary research evidence only or evidence based on consensus opinion only.

Summarized Comments

Add Comment

* Not sure if this should be a requirement for all, but it certainly should, when situations would suggest a problem.

Variation in Results

Ratings-based Rank

Relevance	84
Actionability	23
Overall Importance	81

Stakeholder Rank

Academics	52
Clinicians	53
Consumers	75
Decision Makers	66

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Special Group Rank

First Nations	70
Rural Areas	73
Federal Stakeholders	64

Regional Rank

BC	AB	SK	MB	ON	QC	NB	NS	PE	NL	YT	NT	NU
32	22	85	84	61	77	131	95	70	21	15	27	16

Overall Rank

SA15c (B570)

Distribution of Survey Respondent Ratings

Relevance

100
90
80
70
60
50
40
30
20
10
0

Low

High

Actionability

100
90
80
70
60
50
40
30
20
10
0

Low

High

Overall Importance

100
90
80
70
60
50
40
30
20
10
0

3 = can live without
2 = nice to have
1 = indispensable

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The views expressed herein do not necessarily represent the official policies of Health Canada