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

Saskia Schawo; Renske Hoefman; Vivian Reckers-Droog; Liesbet Lawerman-van de Wetering; Yifrah Kaminer; Werner Brouwer; Leona Hakkaart-van Roijen

doi:10.1007/s10198-023-01633-3

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

Eur J Health Econ. 2023 Sep 27. doi: 10.1007/s10198-023-01633-3. Online ahead of print.

Authors

Saskia Schawo¹, Renske Hoefman¹, Vivian Reckers-Droog², Liesbet Lawerman-van de Wetering¹, Yifrah Kaminer³, Werner Brouwer¹, Leona Hakkaart-van Roijen¹

Affiliations

¹ Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
² Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands. reckers@eshpm.eur.nl.
³ University of Connecticut School of Medicine, University of Connecticut, Farmington, USA.

PMID: 37755542
DOI: 10.1007/s10198-023-01633-3

Abstract

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.

Keywords: Adolescent; Delinquency; Discrete choice experiment; Economic evaluation; Mental health; Preference scores; Preference-based measure; Substance abuse.

Grants and funding

157004007/ZONMW_/ZonMw/Netherlands