Reese, Thomas J.; Tindle, Hilary A.; Bachmann, Justin.; Wright, Adam.; Ancker, Jessica S.; Audet, Carolyn M.; Shah, Mauli V.; Steitz, Bryan D.; Levin, Michael H.; Kast, Kristopher A.; Marcovitz, David.; von Horn, Amanda.; Kelley, A. Taylor.; Bridges, John F. P. (2026).听.听Addiction.听
Measurement-based care is a structured way for clinicians to track treatment progress by using repeated, standardized check-ins to guide decisions. In substance use treatment, this approach can improve outcomes, but it is often difficult to use because many questionnaires are long. This review looked at whether very short patient-reported outcome measures, or PROMs, which ask patients to rate a single issue with one question, can work well in this setting. The researchers searched the medical literature for studies of single-item PROMs in adults receiving substance use treatment and evaluated how well these measures performed, including whether they measured what they were supposed to measure, gave consistent results, predicted outcomes, and detected change over time. They found 35 studies covering 68 single-item measures and more than 50,000 participants across nine clinical topics. Fifteen measures had enough evidence to be considered strong overall. The best-supported single-item measures were those assessing craving, readiness for treatment, and self-efficacy, meaning a person鈥檚 confidence in their ability to succeed. In some cases, these single-question measures worked as well as longer questionnaires. However, more than half of the measures did not yet have clear cutoffs for interpreting scores or enough evidence that they could reliably detect improvement or worsening over time. Overall, the review suggests that single-item PROMs can be practical and useful tools for routine monitoring in substance use treatment, especially when they have strong evidence and clear scoring thresholds, but some are better used alongside other measures rather than alone.
FIGURE 1
Coverage of single-item patient-reported outcome measure studies across substance type and clinical construct. Darker boxes indicate a higher number of studies.