Background: Routine collection of patient-reported outcome measures (PROMs) enables the monitoring of client progress and assessment of outcomes, however, their use in alcohol and other drug treatment settings has been limited.


Method: We conducted a stepped-wedge cluster randomised trial to increase the uptake of PROMs within a large, non-government alcohol and other drug treatment provider, Lives Lived Well, across services in QLD and NSW. From January 2023 to November 2023, clinicians from 8 geographical clusters were sequentially trained on outcome measures, assessment and provision of feedback to clients. During the trial, there was a shift in procedures from the completion of PROMs with clients in the first session to clients completing PROMs before enrolment.


Results: There were 2938 enrolments in the pre-intervention stage and 5478 in the post-intervention stage. 43% of clients in the pre-intervention group enrolled into treatment, compared with 53% during the trial. Among clients who enrolled in treatment, we found significant increases in the proportion completing baseline (82% vs 59%), one-month (35% vs 24%) and three-month (18% vs 12%). Among those who turned up to treatment, we found baseline (97% vs 91%) and one-month (47% vs 43%) completion significantly increased, but not three-month follow-up (24% vs 22%). Since follow-up rates were still low, we compared proportions of PROM completion of those who were still in treatment at the time the follow-up PROMs were due and found no differences between the one-month (65% vs 68%) and three-month (59% vs 61%).


Discussions and Conclusions: The vast majority of clients were able to self-complete PROMS before treatment. Training clinicians in PROM assessment and feedback increased completion rates for PROM. PROMs can be collected and self-completed by clients in AOD treatment settings. Further attention on understanding how PROMS are used in treatment will assist in increasing the uptake of follow-up PROMS.