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What is it?

The Treatment Outcomes Profile (TOP) is a new drug treatment outcome monitoring tool that has been developed by the NTA in partnership with drug treatment providers in over 70 sites across England. It is applicable for use in all of the structured treatment modalities as defined by Models of Care for Treatment of Adult Drug Misusers: Update 2006. (Reference: The Treatment Outcomes Profile (TOP): A Structured Interview for the Evaluation of Substance Misuse Treatment. Marsden J, Farrell M, Bradbury C, Dale-Perera A, Eastwood B, Roxburgh M & Taylor S (2008). Development of the treatment outcomes profile. Addiction, 2008; 103 (9): 1450 -1460)

For the first time, service users, clinicians, service managers and commissioners will be able to obtain objective and comparable data about real improvements in service users' lives that will be able to inform and improve practice on both an individual and strategic level.

The TOP is a simple set of questions that will improve clinical practice by enhancing assessment and care plan reviews for clients. The data it provides will improve performance monitoring. Data will be reported into the National Drug Treatment Monitoring System (NDTMS) from October 2007 and results fed back to providers and commissioners from March 2008.

There will also be monthly exception reports from NDTMS on non-returns and multiple submissions.

When to complete it?

The TOP should be completed at three key treatment stages:

Treatment Start

• The TOP should be completed within two weeks either side of the date that a client started structured drug treatment.
• If the TOP is completed in the two weeks after the treatment start date it is important to ensure that the recall period focuses on the 28-days before treatment start and NOT the 28-days from the date that the TOP is completed.
• The treatment start TOP provides important information about the clients drug use before treatment and acts as a baseline for comparison with subsequent Review and Exit TOP’s.

Review TOP (3 months)

• It is good practice to conduct regular care plan reviews that are usually completed in 12 week (3 month) cycles. It is recommended that the TOP is completed as part of this process.
• However, the TOP only needs reporting to the NDTMS every 26 weeks (6 months).

Treatment Exit

• TOP should be completed within two weeks either side of the date that the client exits structured treatment.
• If the client is referred on to another structured treatment provider a Treatment Exit TOP is not required.

How to complete the TOP

Start by entering

Name and identifiers of your client (date of birth and gender)
Your name
Date of assessment
The stage at which the TOP is being completed (Treatment Start, Review, Treatment Exit, or post Treatment Exit.)

Types of responses:

Timeline - Invite the client to recall the number of days in each of the past four weeks on which they did something; for example, the number of days they used heroin. You then add these to create a total for the past four weeks in the TOTAL box
Yes and no - a simple tick for yes or no, then a "Y" or "N" in the blue NDTMS box
Rating scale - a 20-point scale from 0=poor to 20=good. Together with the client, mark the scale in an appropriate place and then write the equivalent score in the box.

You should aim to ask and complete every question. Do not leave any of the blue boxes blank. Enter N/A if the client refuses to answer a question or, after prompting, cannot recall.

Do you want to complete a TOP on your client right now?

Go to Treatment Outcomes Profile