Quality assurance in drug-related treatment in the European Union

							 Quality assurance in drug-related
 treatment in the European Union and
 Norway




Ulrik Solberg, Lisbon, 28th of November 2003
   What is quality assurance?

• A tentative definition: ’A systematic attempt to
  monitor, keep track or improve the quality of services
  provided at treatment centres’
• Hence, not only success rates but also monitoring
  and surveying
• Not linked only to outcomes but also to processes
   Examples of quality assurance

• Formal requirements (for treatment services)
• Standards (for treatment)
• Training (of staff)
• Monitoring (of clients and outcomes)
• Evaluation and research (of retention rates,
  outcomes, satisfaction, discharge etc.)
 EU Action Plan on Drugs 2000-2004

Under strategy target 3:
3.1.3.3 Member States to define clear guidelines
  for the standards and goals of treatment
  services and to ensure the evidence based
  evaluation of the treatment according to those
  guidelines. Emphasis should be given to a
  scientific evaluation of different treatment
  strategies.
   National Reports on quality assurance

• Generally little information provided
• Big differences in ways of reporting
• Wide oscillations in quality assurance mechanisms in
  place
   Other factors in comparing quality assurance

• Organisation of drug-related treatment plus financing
  models of treatment vary
• Difficulties with translations and accurate
  connotations – and all into English
• Big chunk of soft and not easily comparable data
• Unique national contexts
   EMCDDA web-publication

• Summaries of National Report parts
• National overviews according to ’examples of quality
  assurance’
• Generally, quality assurance mechanisms apply to
  both treatment and social reintegration
• No comprehensive European overview nor cross-
  country comparisons
   EMCDDA web-publication

• Quality assurance at three levels:
  1. Centre itself, 2. Regional level, 3. National level
  (five examples of quality assurance applicable to all
  levels)
• But quality assurance can also be; co-operation
  between services or referral
• Intra or interinstitutional measure
   Improvement of data and comparability

• Expert meeting in October 2002 on quality assurance
• Participation from current and future Member States
• Development of first draft of new data collection tool
• Later decided to be a structured questionnaire –
  including part on quality assurance
   Enlargement and future

• Increasingly structured and data collection
• Standard table on drug-related treatment availability
• Structured questionnaire – for more qualitative data
• Testing in Member States from February 2004
• Implementation from 2005
Future perspectives
 • 80’s and 90’s witnessed substantial increase in
   availability of drug-related treatment
 • Future, focus on assuring quality of the drug-
   related treatment provided
 • Now, many initiatives planned or conceived
 • Future, implementation and consolidation of
   such plans.