Assertive Community Treatment for Patients Suffering From Substance Use Disorders

Completed

• Conditions: Substance Use Disorders
• Interventions: Other: Treatment As Usual; Other: Assertive Community Treatment

• Registration Number: NCT03623178
• Lead Sponsor: University Hospital, Geneva

Brief Summary

According to the World Health Organization the population suffering from addiction problems is increasing. This population is characterized by multiple needs at the medico-psychosocial level. However, some of these patients, a particular subgroup that we are going to be interested in the so-called "high need" user group, find it difficult to access and stay in outpatient treatment programs. Persons with substance use disorder often present a chaotic use of the health system, including a high number of hospitalizations in times of crisis. These individuals also show very low utilization of health care services, accompanied by social marginalization. This can be related to relapses and poor social functioning. A high number of relapses occur particularly at the end of hospitalization. Community Interventions, such as Assertive Community Treatment (ACT) should increase the adherence of these patients to treatment by accompanying them in the community and helping them during sensitive and crisis periods. One of the objectives of the study is to evaluate the impact of ACT on the time until service disengagement, measuring treatment adherence. The secondary objectives of this study will be to see the effect of ACT on duration and type of hospitalizations, as well as the number of emergency room visits. The investigators will focus on the impact of ACT on the participant's medico-psycho-social network, substance use and other psychological variables. The investigators will also evaluate his or her psychiatric symptoms and global and social functioning. Life satisfaction and satisfaction with the care received will also be measured. The study will investigate this through questionnaires at the beginning of care, at three months, six months and 12 months after the start of the ACT intervention.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-12-01
• Status Verified: 2018-08
• Study First Submitted: 2018-08-01
• Study First Submitted QC: 2018-08-07
• Study First Posted: 2018-08-09
• Primary Completion: 2023-01-01
• Study Completion: 2023-12-01
• Last Update Submitted: 2025-05-18
• Last Update Posted: 2025-05-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

• Substance use disorder
• Competent subjects, able to give informed consent
• French speaking

Exclusion Criteria

• Evidence of organic brain disease or learning disability based on the chart review.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Treatment As Usual	Treatment As Usual	patients with DSM-5 Diagnosis of SUD which do not respond to ACT inclusion criteria
Assertive Community Treatment	Assertive Community Treatment	patients with DSM-5 Diagnosis of SUD and one of the following criteria (1) present important functional difficulties, in at least one of the following areas: everyday life activities and maintaining a supportive social network, for minimum two years. or (2) difficulties to attend their health care appointments, during the last 3 months.

Primary Outcome Measures

Name	Time	Method
Treatment adherence	at 12 months	Number of days until service disengagement

Secondary Outcome Measures

Name	Time	Method
Service use	at 12 months	Number of hospital admissions and number of days in hospital
Patient network	0, 3, 6, 12 months	Number of persons in network
Number of ER visits	0, 3, 6, 12 months	Number of ER visits reviewed on patient file
Addictive behaviour	0, 3, 6, 12 months	Alcohol, Smoking and Substance Involvement Screening Test (ASSIST. V.3 French)
General psychiatric symptoms	0, 3, 6, 12 months	Health of Nation Outcome Scale - French version (HoNOS-F): scores 0 - 52 (higher score = more psychiatric symptoms)
Global Functioning	0, 3, 6, 12 months	World Health Organization Disability Assessment Schedule (WHODAS)
General life satisfaction: Satisfaction With Life Scale	0, 3, 6, 12 months	Satisfaction With Life Scale: scores 5 - 35 (higher score = higher life satisfaction)

Trial Locations

Locations (1)

Service d'addictologie, HUG; 🇨🇭 Geneva, Switzerland