What outcomes to measure in addiction treatment? A COS for substance use disorder

What is it about?

Despite decades of research and clinical practice in addiction treatment, no globally agreed minimum standard exists for which outcomes should be measured when treating substance-related and addictive disorders. This paper reports the work of an international, multidisciplinary working group convened by the International Consortium for Health Outcomes Measurement (ICHOM), which brought together researchers, clinicians, people with lived experience of addiction, and policymakers from across the world. The group conducted a systematic review of existing outcome measures, then used a structured consensus process to agree a globally applicable minimum set of patient-centred outcome measures covering the full range of substance-related and addictive disorders. The resulting consensus set includes outcome domains, specific measures, and case-mix variables, and is freely available as an open-access data dictionary and reference guide to support adoption in clinical and research settings.

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Why is it important?

he absence of a global standard for addiction treatment outcomes has severely limited the comparability of research evidence, the quality of clinical benchmarking and the ability to monitor treatment effectiveness across different systems and countries. Addiction treatment research has suffered from exactly the problem that the ORBITAL project identified for alcohol brief interventions: too many outcomes measured in too many different ways, making synthesis and comparison near impossible. This consensus set addresses that gap at the level of all substance-related and addictive disorders, providing a foundation for internationally comparable outcome monitoring that could transform the quality of evidence available to clinicians, commissioners and policymakers. Development through ICHOM's rigorous, inclusive process, involving patients alongside specialists from multiple disciplines and countries, substantially strengthens the legitimacy and adoption potential of the final set.