Journal of Alcoholism & Drug Dependence
Open Access

Abstract

Use of Addiction Severity Index in a Nigerian Drug Abuse Treatment Unit: A Clinical Audit

Peter Olutunde Onifade, Olubisi Olasunkanmi Osisanwo, Oluronke Ayokanmi Ganzallo, Akinwanda Owuladewa Akinhanmi, Sunday M Amosu, Edward Babatunde Somoye, Temitope Ogundare and Taiwo Abosede Adamson

Background: The Addiction Severity Index (ASI) is a useful research and clinical tool. It has been used extensively but not in Nigeria. This study aimed to audit the implementation of ASI as a clinical tool in a Nigerian drug abuse treatment unit.

Methods: This is a complete-cycle clinical audit with mixed method design: Cross-sectional survey and Focused Group Discussion (FGD) were used.

Results: The use of ASI for the patients during the first phase of the audit cycle was less than 50%. This increased significantly to 78% at the second phase (x²=13.2, d=1, p<0.001). Similarly, significantly higher proportion of the patients had their ASI narrative reports/master problem lists (x²=11, d=1, p=0.001) and treatment plans (x²=3.88, d=1, p=0.038) presented at the weekly ward rounds of the therapeutic team. The finding is the same for ASI based treatment plan review and update. Problems with the use of ASI could be classified into factors related to the instrument, training, structure of staff duties, and schedule for the unit’s activities.

Conclusion: The problems challenging the use of Addiction Severity Index in clinical practice in this setting is similar to what obtain elsewhere. But the efforts at implementing the use of ASI for assessment, treatment planning and outcome evaluation in this African setting is yielding positive results at an early stage. Therefore the practice of using ASI in developing countries like Nigeria is feasible. To this end attention should be focused on staff continual training and reorganization of staff schedule of duty.