A Longitudinal Collaborative Care Model for Patients With Opioid Problems: Emergency Department Longitudinal Integrated Care (ED-LINC)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Opioid-use Disorder
- Sponsor
- University of Washington
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Follow up Completion Rates
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The overarching goal of this investigation is to develop and determine the feasibility of a multi-component intervention adapted from a collaborative care framework initiated in the ED for patients at risk for opioid use disorder. This study will provide important feasibility information for future studies of ED-LINC. The collaborative care intervention (ED-LINC) will be supported by a novel Emergency Departement (ED) health information exchange platform.
Detailed Description
The overarching goal of this investigation is to develop and determine the feasibility of a multi-component intervention adapted from a collaborative care framework initiated in the ED for patients at risk for opioid use disorder. According to the 2015 national survey on drug use and health, an estimated 3.8 million individuals over 12 years of age were currently misusing opioid pain relievers. An additional 329,000 people use heroin. The Emergency Department (ED) is currently at the forefront of this public health emergency and often a place where patients come for treatment of overdose and for treatment of medical problems related to illicit opioid use. Overall, the goal is to establish the feasibility of a multi-component intervention called 'Emergency Department Longitudinal Integrated Care (ED-LINC)' which is guided by principles of collaborative care and is comprised of components that are evidence-based. ED-LINC is initiated from the ED and continues longitudinally for patients at-risk for opioid use disorder.
Investigators
Lauren Whiteside
Assistant Professor, School of Medicine: Department of Emergency Medicine
University of Washington
Eligibility Criteria
Inclusion Criteria
- •Aged 18-65
- •Patients with at least one risk factor for opioid use disorder via the EMR pre-screen
- •Patients with score of ≥ 4 on the NIDA modified ASSIST for illicit opioids (e.g. heroin) OR a score of ≥ 4 on the NIDA modified ASSIST for prescription opioids
- •Currently have a phone
- •Able to provide a phone number and one additional piece of contact information
Exclusion Criteria
- •They are incarcerated or under arrest
- •Non-English speaking
- •Live beyond a 50 mile radius of HMC
- •Require active resuscitation in the ED or other clinical area at the time of RA approach
- •Are receiving palliative care services or hospice care for a chronic illness such as metastatic cancer
- •Are in the ED or hospital for a primary psychiatric emergency such as suicidal ideation or attempt
- •Receiving chronic opioid therapy (COT) defined as prescription opioids for most days out of the last 90 days for a chronic pain condition
- •In the ED for sexual assault
Outcomes
Primary Outcomes
Follow up Completion Rates
Time Frame: 6 months
The number of participants who completed follow-ups at 6 month time point.
ED-LINC Intervention and Usual Care Process Outcomes
Time Frame: 6 months
Number of participants that received at least 1 ED-LINC element
Implementation Appropriateness
Time Frame: 6 months
Participants randomized to ED-LINC care were asked about the appropriateness of interventional activities.by rating the agreeability of the statement "ED LINC seemed fitting and suitable"
Refusal Rate
Time Frame: Baseline
Percentage of subjects who agree to participate in screening survey prior to determining eligibility status. Potential subjects identified by suspected risky substance use history based on EMR review
ED-LINC Satisfaction
Time Frame: 6 months
Client Satisfaction Questionnaire (CSQ-8) questions (8-32) will be used to assess satisfaction with ED-LINC, in which greater numbers designate higher satisfaction (32 is maximum or highest satisfaction rating possible)
Perception of Care Coordination
Time Frame: 6 months
The Patient Assessment of Chronic Illness Care - Coordination (PACIC-C) questions will be asked of all participants, where greater numbers indicate perception was more coordinated (greater number is better). For the scale, scores must be discrete numbers, with a minimum possible value of 5 and maximum possible value of 25.
Secondary Outcomes
- Substance Use(6 months)
- Health Care Utilization(6 months)