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Peer Support in Alcohol Dependence

Not Applicable
Not yet recruiting
Conditions
Alcohol Use Disorder
Interventions
Behavioral: Quality life questionnaire AQoLS
Behavioral: Quality life questionnaire Euroqol EQ-5D-5L
Other: Peer support consultations
Registration Number
NCT06381609
Lead Sponsor
Hospices Civils de Lyon
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.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
626
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control GroupQuality life questionnaire AQoLS313 patients will be recruited over 3 years in the control group. Patients will receive "as usual" outpatient abstinence-maintenance follow-up, with consultations of all kinds (medical, psychological, nursing, group, etc.)
Peer support GroupQuality life questionnaire Euroqol EQ-5D-5L313 patients will be recruited over 3 years in the peer support group. Patients will be accompanied by an addiction peer support specialist, as part of an "add-on" follow-up compared with conventional follow-up (same management as in the control group).
Control GroupQuality life questionnaire Euroqol EQ-5D-5L313 patients will be recruited over 3 years in the control group. Patients will receive "as usual" outpatient abstinence-maintenance follow-up, with consultations of all kinds (medical, psychological, nursing, group, etc.)
Peer support GroupQuality life questionnaire AQoLS313 patients will be recruited over 3 years in the peer support group. Patients will be accompanied by an addiction peer support specialist, as part of an "add-on" follow-up compared with conventional follow-up (same management as in the control group).
Peer support GroupPeer support consultations313 patients will be recruited over 3 years in the peer support group. Patients will be accompanied by an addiction peer support specialist, as part of an "add-on" follow-up compared with conventional follow-up (same management as in the control group).
Primary Outcome Measures
NameTimeMethod
Unplanned cessation of care at 6 monthsAt 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 Outcome Measures
NameTimeMethod
average number of standard drinks declared per weekAt inclusion, 3 and 6 months after inclusion
Euroqol-5D-5L questionnaire scoreAt 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.

Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scoreAt inclusion, 3 and 6 months after inclusion
Montgomery-Åsberg Depression Rating Scale (MADRS) scoreAt inclusion, 3 and 6 months after inclusion

Changes in levels of depression will be measured using MADRS

type of psychostimulant useAt inclusion, 3 and 6 months after inclusion
State-Trait Anxiety Inventory (STAI-Y) scoreAt inclusion, 3 and 6 months after inclusion

Changes in levels of anxiety will be measured using STAI-Y

Cannabis Use Disorders Identification Test - Revised (CUDIT-R) scoreAt inclusion, 3 and 6 months after inclusion

Changes in the severity of cannabis use will be measured by the CUDIT-R score

frequency of opioid useAt inclusion, 3 and 6 months after inclusion
Health Care Satisfaction Questionnaire (HCSQ) scoreAt 6 months after inclusion

Patient's satisfaction will be measured by HCSQ questionnaire

Alcohol Quality of Life Scale (AQoLS) scoreAt inclusion, 3 and 6 months after inclusion

Changes in quality of life will be measured using the AQoLS

type of opioid useAt inclusion, 3 and 6 months after inclusion
frequency of psychostimulant useAt inclusion, 3 and 6 months after inclusion
Number of unfulfilled consultations6 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.

Number of AUD criteria according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5)At inclusion, 3 and 6 months after inclusion
Fagerström test scoreAt inclusion, 3 and 6 months after inclusion

Tobacco use will be measured by the Fagerström test

Service organization descriptionBefore setting up of the study
AIM scoreAt 6 months after inclusion

AIM score measured in patients

Adoption of interventionAfter 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 fidelityAfter 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

Number of hospitalisationsAt 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)

Description of type of support and missions performed by Peer SupportAfter last visit of last patient (around 3,5 years after first inclusion)
Acceptability of Intervention Measure (AIM) scoreAfter last visit of last patient (around 3,5 years after first inclusion)

AIM score measured in Peer Support and medical staff

Trial Locations

Locations (5)

CH Le Vinatier

🇫🇷

Bron, France

Bichat Hospital

🇫🇷

Paris, France

CHS St Anne

🇫🇷

Paris, France

GH Nord, Hospices Civils de Lyon

🇫🇷

Lyon, France

Hôpital Beaujon

🇫🇷

Clichy, France

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