Transitional Case Management for Patients Suffering From Substance Use Disorders

Completed

• Conditions: Substance Use Disorders

• Registration Number: NCT03551301
• 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. They often present a chaotic use of the health system, including a high number of hospitalizations in times of crisis. They 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. Interventions in the field of addiction, such as Transitional Case Management (TCM) should increase the adherence of these patients to treatment by accompanying them in the sensitive period following hospitalization. One of the objectives of the study is to evaluate the impact of TCM on the number, duration and type of hospitalizations, as well as the number of emergency room visits. The investigators will also measure the duration until the possible future hospitalization, after the TCM. The secondary objectives of this study will be to see the effect of TCM on adherence to outpatient treatment. The investigators will focus on the impact of follow-up 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 investigators will compare the population treated by the TCM with the other users of the addiction service who are hospitalized. The study will investigate this through questionnaires at the beginning of care, at one month, three months, six months and 12 months after the start of TCM management.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-09-01
• Study First Submitted: 2018-04-24
• Study First Submitted QC: 2018-05-28
• Study First Posted: 2018-06-11
• Primary Completion: 2019-12-04
• Study Completion: 2020-04-01
• Status Verified: 2024-03
• Last Update Submitted: 2024-03-19
• Last Update Posted: 2024-03-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Substance use disorder
• Hospitalisation at recruitment
• Substance Use Disorder according to the DSM-5 and one of the following criteria:
• No preexisting outpatient follow-up care or regular follow-up care
• More than three emergency room visits during the last 12 months
• More than three hospitalizations in psychiatric hospital during the last 12 months
• More than 40 hospitalization's days during the last 12 months
• First hospitalization for a SUD

Exclusion Criteria

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Hospital days	at 12 months	Number of days in hospital

Secondary Outcome Measures

Name	Time	Method
Addictive behaviour	0, 1, 3, 6, 12 months	Alcohol, Smoking and Substance Involvement Screening Test (ASSIST. V.3 French)
Type of admission (planned versus unplanned)	0, 1, 3, 6, 12 months	Type of admission (planned versus unplanned) reviewed on patient file
Number of ER visits	0, 1, 3, 6, 12 months	Number of ER visits reviewed on patient file
General psychiatric symptoms	0, 1, 3, 6, 12 months	Health of Nation Outcome Scale - French version (HoNOS-F): scores 0 - 52 (higher score = more psychiatric symptoms)
General life satisfaction	0, 1, 3, 6, 12 months	Satisfaction With Life Scale: scores 5 - 35 (higher score = higher life satisfaction)
Patient network	0, 3, 6, 12 months	Number of persons in network
Time to first readmission to hospital	0, 1, 3, 6, 12 months	Number of days to first readmission
Treatment adherence	0, 1, 3, 6, 12 months	percentage of attended outpatient appointments reviewed on patient file
Number or Transitional Case Management interventions	0, 1, 3, 6, 12 months	Number or Transitional Case Management interventions
Global functioning	0, 1, 3, 6, 12 months	World Health Organization Disability Assessment Schedule (WHODAS)
Service use	at 12 months	Number of hospital admissions
Advance directives written by the participants	at Baseline	Advance directives written by the participant (yes - no)

Trial Locations

Locations (1)

Service d'addictologie HUG; 🇨🇭 Geneva, Switzerland