Alcohol-Related Disorders, Drug Use Disorders, Substance Use Disorder (SUD)
Conditions
Keywords
Implementation Science, Care Navigation, Drug Use Disorders, Quality Improvement, Behavioral Health
Brief summary
The Addressing Barriers to Care for Substance Use Disorder Trial (ABC-SUD) is a cluster-randomized crossover trial, with clinicians (care coordinators) as the unit of randomization. This study will be conducted in a mental health access center within the Washington region of Kaiser Permanente. As part of usual care, patients contact the mental health access center and speak to a care coordinator to obtain an appointment with or contact information for potential venues to obtain treatment for substance use disorder. The experimental intervention, Care Navigation, will be evaluated for its potential to increase engagement in substance use disorder treatment among patients who contact the mental health access center. Care Navigation will be delivered by study care navigators, who are distinct from the health system's care coordinators.
Detailed description
The ABC-SUD Trial is a cluster-randomized crossover trial evaluating the effectiveness of care navigation in increasing engagement in substance use disorder treatment. Each care coordinator is randomly assigned to a study arm (services as usual or care navigation) at the beginning of the trial (period 1), and halfway through the trial, switches to the other study arm (period 2). The patient population includes individuals who are seeking substance use treatment and are evaluated by enrolled care coordinators. During periods in which care coordinators are assigned to the intervention arm, care coordinators offer care navigation to patients and utilize an electronic health record referral tool to refer patients to care navigators. This tool is disabled for care coordinators during the period in which they are assigned to the control arm. This study will employ an encouragement design, where patients who speak with intervention care coordinators are offered care navigation, but patients choose whether to participate in care navigation. Primary analyses will follow an intent-to-treat principle whereby care coordinators and patients will be analyzed according to the intervention arm to which they are assigned regardless of the subsequent sequence of events.
Interventions
BEHAVIORALCare Navigation
Care navigation is an intervention that seeks to help patients engage in substance use treatment by increasing motivation and reducing barriers to accessing treatment. The care navigator helps the patient engage in the treatment plan established by the mental health care coordinator.
Sponsors
Kaiser Permanente
National Institute on Drug Abuse (NIDA)
Stanford University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Masking description
All study outcomes are extracted from electronic health records and healthcare claims data that cannot be manipulated by the study team.
Intervention model description
Care coordinators will be randomized to care navigation arm or services as usual arm at study outset and switch to the opposite arm halfway through the study.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Clinician (Care Coordinator) Inclusion Criteria: * Conducts assessment and treatment planning visits in the mental health access center * Has been employed for at least 1 month * Has completed trainings related to their clinical role in the health system * Scheduled to conduct assessments Clinician
Exclusion criteria
None Patient Inclusion Criteria (eligibility for analyses): * Visits an enrolled care coordinator during the patient eligibility period * ≥ 18 years of age at the time of the visit * Has an assessment and treatment planning visit for SUD with an enrolled care coordinator Patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Engagement in treatment for substance use disorder | 48 days | Completion of ≥ 3 treatment visits for substance use disorder within 48 days of their assessment visit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Initiation of treatment for substance use disorder | 30 days | Completion of ≥ 1 treatment visit for substance use disorder within 30 days of their assessment visit |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORJoseph E Glass, PhD, MSW
Chestnut Health Systems
Outcome results
None listed