Alcohol Use Disorder
Conditions
Keywords
Peer support, Addiction, Alcohol
Brief summary
Alcohol use disorder (AUD) affects between 4% and 6% of French adults, and requires appropriate medical treatment. However, 20-40% of patients with AUD are lost to follow-up at an early stage. Consequently, it is important for addiction departments to implement and evaluate innovative tools and interventions, including the involvement of peer support, to help patients remain in care, and to assess whether peer support has a positive impact on their clinical outcome. Addiction peer support specialists (APSSs) are individuals who have personally experienced addiction, and who have decided to use their experience to assist other people going through a similar situation, after completing a specific official graduation. Compared to other caregivers, APSSs may induce in patients a sense of identification which could improve the patient motivation to engage and remain in care. This is the main hypothesis and the main scientific objective of the PEERSIAD study, which will aim to confirm that accompanying patients with AUD using APSSs after alcohol detoxification, reduces the rate of lost-to-follow-up and improves the overall clinical outcome.
Interventions
BEHAVIORALQuality life questionnaire AQoLS
Quality life questionnaire AQoLS will be completed by patients of both arms at inclusion, three and six months after inclusion
BEHAVIORALQuality life questionnaire Euroqol EQ-5D-5L
Quality life questionnaire Euroqol EQ-5D-5L will be completed by patients of both arms at inclusion, three and six months after inclusion
OTHERPeer support consultations
For patients included in the Peer support group, eight mandatory consultations with a peer support specialist will be performed between the inclusion visit and during the three following months. Patients can request additional consultations with the peer support specialist during the 6 first months of follow-up
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NON_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
* Aged ≥ 18 * Socially insured * Meeting DSM-5 criteria for alcohol use disorder (AUD) * Abstinent from alcohol and involved in supervised alcohol withdrawal for at least 5 days and no more than 21 days (outpatient or inpatient) * Starting a post-detoxification outpatient program
Exclusion criteria
* Other severe substance use disorder, i.e. DSM-5 criteria ≥ 6 (excluding tobacco) * Patient under protective measure (safeguard measure, guardianship) or deprived of liberty or in ordered care and hospitalization measures without consent. * Inability to communicate and express oneself orally in French, compromising the possibility of exchanges between the Peer support and the patient. * Psychiatric or cognitive comorbidities making inclusion impossible, at the investigator's discretion. * Individual accompaniment by a Peer support in the 15 days prior to inclusion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Unplanned cessation of care at 6 months | At 6 months after inclusion | The unplanned cessation of care at 6 months, excluding consultations with an APSS, with no further contact in the following month, is defined as having had a last planned consultation that was not fulfilled between M0 and M6 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of unfulfilled consultations | 6 months after inclusion | The number of unfulfilled consultations (scheduled consultations, excluding Peer Support consultations, without patient's visit with or without justification) over the 6-month study follow-up period, collected from the medical records of the addictology department. |
| Euroqol-5D-5L questionnaire score | At inclusion, 3 and 6 months after inclusion | The differential cost-utility ratio, in relation to the innovative strategy including a Peer Support, will be assessed using the Euroqol-5D-5L questionnaire (EQ-5D-5L). |
| Difference in costs (in euros) | At 1, 2 and 3 years after the beginning of implementation on French territory | An additional analysis will be carried out if the cost-utility ratio is positive: Difference in costs (in euros) for the payer (French compulsory health insurance) between a scenario in which the innovative management is implemented and disseminated in practice and on French territory, and a scenario in which usual follow-up is maintained. |
| Number of AUD criteria according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) | At inclusion, 3 and 6 months after inclusion | — |
| Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score | At inclusion, 3 and 6 months after inclusion | — |
| average number of standard drinks declared per week | At inclusion, 3 and 6 months after inclusion | — |
| Alcohol Quality of Life Scale (AQoLS) score | At inclusion, 3 and 6 months after inclusion | Changes in quality of life will be measured using the AQoLS |
| State-Trait Anxiety Inventory (STAI-Y) score | At inclusion, 3 and 6 months after inclusion | Changes in levels of anxiety will be measured using STAI-Y |
| Montgomery-Åsberg Depression Rating Scale (MADRS) score | At inclusion, 3 and 6 months after inclusion | Changes in levels of depression will be measured using MADRS |
| Cannabis Use Disorders Identification Test - Revised (CUDIT-R) score | At inclusion, 3 and 6 months after inclusion | Changes in the severity of cannabis use will be measured by the CUDIT-R score |
| type of opioid use | At inclusion, 3 and 6 months after inclusion | — |
| Description of type of support and missions performed by Peer Support | After last visit of last patient (around 3,5 years after first inclusion) | — |
| type of psychostimulant use | At inclusion, 3 and 6 months after inclusion | — |
| frequency of psychostimulant use | At inclusion, 3 and 6 months after inclusion | — |
| Fagerström test score | At inclusion, 3 and 6 months after inclusion | Tobacco use will be measured by the Fagerström test |
| Health Care Satisfaction Questionnaire (HCSQ) score | At 6 months after inclusion | Patient's satisfaction will be measured by HCSQ questionnaire |
| Number of hospitalisations | At 6 months after inclusion | Measurement of the number of hospitalisations related or not to the AUD and the ratio of total hospital days to number of hospital admissions (based on medical records and patient interviews) |
| Service organization description | Before setting up of the study | — |
| Acceptability of Intervention Measure (AIM) score | After last visit of last patient (around 3,5 years after first inclusion) | AIM score measured in Peer Support and medical staff |
| AIM score | At 6 months after inclusion | AIM score measured in patients |
| Adoption of intervention | After last visit of last patient (around 3,5 years after first inclusion) | adoption of intervention will be assessed through semi-structured interviews and measurement of the number of patients followed-up versus the number of eligible patients, refusals to be accompanied by APSS, and premature discontinuation of follow-up |
| Intervention fidelity | After last visit of last patient (around 3,5 years after first inclusion) | intervention fidelity will be assessed by monitoring APSS activity indicators, describing deviations from the protocol and semi-structured interviews |
| frequency of opioid use | At inclusion, 3 and 6 months after inclusion | — |
Countries
France
Contacts
Primary ContactBenjamin ROLLAND, Professor
Backup ContactNathalie Perreton
Outcome results
None listed