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Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients

Open access
McNeely, Jennifer, Wu, Li-Tzy, Subramaniam, Geetha, Sharma, Gaurav, Cathers, Lauretta A., Svikis, Dace, Sleiter, Luke, Russell, Linnea, Nordeck, Courtney, Sharma, Anjalee, O'Grady, Kevin E., Bouk, Leah B., Cushing, Carol, King, Jacqueline, Wahle, Aimee, Schwartz, Robert P.·2016·Annals of Internal Medicine
DOI 10.7326/m16-0317PMC PMC5291717
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Abstract

BACKGROUND: Substance use, a leading cause of illness and death, is underidentified in medical practice. OBJECTIVE: The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) tool was developed to address the need for a brief screening and assessment instrument that includes all commonly used substances and fits into clinical workflows. The goal of this study was to assess the performance of the TAPS tool in primary care patients. DESIGN: Multisite study, conducted within the National Drug Abuse Treatment Clinical Trials Network, comparing the TAPS tool with a reference standard measure. (ClinicalTrials.gov: NCT02110693). SETTING: 5 adult primary care clinics. PARTICIPANTS: 2000 adult patients consecutively recruited from clinic waiting areas. MEASUREMENTS: Interviewer- and self-administered versions of the TAPS tool were compared with a reference standard, the modified World Mental Health Composite International Diagnostic Interview (CIDI), which measures problem use and substance use disorder (SUD). RESULTS: Interviewer- and self-administered versions of the TAPS tool had similar diagnostic characteristics. For identifying problem use (at a cutoff of 1+), the TAPS tool had a sensitivity of 0.93 (95% CI, 0.90 to 0.95) and specificity of 0.87 (CI, 0.85 to 0.89) for tobacco and a sensitivity of 0.74 (CI, 0.70 to 0.78) and specificity of 0.79 (CI, 0.76 to 0.81) for alcohol. For problem use of illicit and prescription drugs, sensitivity ranged from 0.82 (CI, 0.76 to 0.87) for marijuana to 0.63 (CI, 0.47 to 0.78) for sedatives; specificity was 0.93 or higher. For identifying any SUD (at a cutoff of 2+), sensitivity was lower. LIMITATIONS: The low prevalence of some drug classes led to poor precision in some estimates. Research assistants were not blinded to participants' TAPS tool responses when they administered the CIDI. CONCLUSION: In a diverse population of adult primary care patients, the TAPS tool detected clinically relevant problem substance use. Although it also may detect tobacco, alcohol, and marijuana use disorders, further refinement is needed before it can be recommended broadly for SUD screening. PRIMARY FUNDING SOURCE: National Institute on Drug Abuse.

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  1. Centers for Disease Control and Prevention (CDC), 2012, MMWR Morb Mortal Wkly Rep, 61, 10
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Metadata

Authors
McNeely, J., Wu, L.-T., Subramaniam, G., Sharma, G., Cathers, L. A., Svikis, D., Sleiter, L., Russell, L., Nordeck, C., Sharma, A., O'Grady, K. E., Bouk, L. B., Cushing, C., King, J., Wahle, A., & Schwartz, R. P.
Affiliations
  • National Institutes of Health (US)
  • From New York University School of Medicine, New York, New York; Duke University Medical Center, Durham, North Carolina; National Institutes of Health, Bethesda, Maryland; The EMMES Corporation, Rockville, Maryland; Virginia Commonwealth University, Richmond, Virginia; Friends Research Institute, Baltimore, Maryland; University of Maryland, College Park, College Park, Maryland; and Duke Translational Research Institute, Kannapolis, North Carolina.
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2016-11-15
Volume
165
Issue
10
Pages
690-699
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m16-0317
PMC
PMC5291717
OpenAlex
W2517443113
Cited by
320
References
68
Citations by year
2026: 47 · 2025: 51 · 2024: 53 · 2023: 41 · 2022: 34 · 2021: 32 · 2020: 26 · 2019: 19 · 2018: 9 · 2017: 8
FWCI
11.23
Type
journal article
Language
en
Open access
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
Funders
National Institute on Drug Abuse (UG1DA013034, U10DA013727, UG1DA040317, UG1DA013035)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Keywords
substance use screening, primary care, tobacco use, alcohol consumption, prescription drug misuse, cannabis use, sedative use, substance use disorders, screening tool validation, sensitivity and specificity, brief screening
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Marijuana Abuse, Female, Humans, Male, Mass Screening, Middle Aged, Primary Health Care, Surveys and Questionnaires, Sensitivity and Specificity, Tobacco Use Disorder, Substance-Related Disorders, Alcohol-Related Disorders, Prescription Drugs, Young Adult

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