Alcohol Abuse, Substance Abuse, Substance, Addiction, Substance Dependence
Conditions
Keywords
substance abuse, Substance Dependence, Substance, addiction, Alcohol Abuse, prevention and control, preventative health services, patient centered care
Brief summary
This component of a larger Center of Research Excellence Grant improves treatment for drug abuse by developing effective linkages between specialty drug treatment and primary health care.
Detailed description
This is a longitudinal two-arm quasi-experimental 3-month alternating off/on design over a 30 month period in which, after a random start, the Linkage condition alternately is added to Usual Care in the Chemical Dependency (CD) clinic and then removed. We compare Usual Care to Usual Care plus Linkage. Follow-up interviews will be conducted at 6, 12 and 24 months. The Linkage intervention includes Usual Care plus 1) sessions on activation regarding overall health behaviors and on selecting a Primary Care physician and communicating with him/her, and 2) a linkage phone call (and/or a facilitated email) with the patient, clinician, and Primary Care physician. The intervention aims to place drug abuse problems in the context of overall health and health care and to activate patients to increase involvement in their own health care.
Interventions
BEHAVIORALLinkage patient activation intervention
Usual Care plus Linkage encompassed Usual Care with the exception that the six 45-min Linkage patient activation education groups replaced the six 45-min Usual Care medical education groups, plus a linkage phone call (and/or a facilitated email) with the patient, clinician, and Primary Care physician. The patient activation intervention components -- 1) six 45-min Linkage sessions on activation regarding overall health behaviors and 2) a linkage phone call (and/or a facilitated email) with the patient, clinician, and PC physician -- were delivered by a clinical psychologist.
Sponsors
Kaiser Foundation Research Institute
Kaiser Permanente
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Research participants will be adult patients at the Kaiser Permanente San Francisco Chemical Dependency Recovery Program, who have completed 2 weeks of treatment.
Exclusion criteria
* Patients with a diagnosis of dementia, mental retardation, or who are actively psychotic or suicidal will be excluded by their clinician.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| patient activation measure | 6 months post baseline | Measured by Patient Activation Measure (PAM) from interview data |
| patient engagement in health care (including patient portal use, familiarity and satisfaction with Primary Care physician, and CD treatment length of stay) | 6 months post baseline | Measured by data from interviews and Electronic Health Record (EHR) |
| Substance use and mental health outcomes | 6 months post baseline | Measures include past 30-day alcohol, drug and total abstinence; Patient Health Questionnaire (PHQ-9) and Addiction Severity Index using interview data |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| patient activation measure at 12 and 24 months | 12 and 24 months post baseline | Measured by Patient Activation Measure (PAM) from interview data |
| Health care utilization and cost | 12 and 24 months post baseline | Measured by data from interviews and adminstrative data |
| patient engagement in health care at 12 and 24 months | 12 and 24 months post baseline | Measured by data from interviews and Electronic Health Record (EHR) |
| Substance use and mental health outcomes at 12 and 24 months | 12 and 24 months post baseline | Measures include past 30-day alcohol, drug and total abstinence; Patient Health Questionnaire (PHQ-9) and Addiction Severity Index using interview data |
Countries
United States
Outcome results
None listed