Brief Intervention in Primary Care for Problem Drug Use and Abuse

Not Applicable

Completed

• Conditions: Substance-Related Disorders
• Interventions: Behavioral: Brief intervention using motivational interviewing

• Registration Number: NCT00877331
• Lead Sponsor: University of Washington

Brief Summary

This study will examine the effectiveness of a brief intervention in a primary care setting to reduce drug use or abuse compared to enhanced care as usual.

Detailed Description

A substantial body of research has established the efficacy and effectiveness of brief interventions (BI) for excessive or "hazardous" alcohol use in patients seen in medical settings. Dissemination projects of brief interventions for alcohol and drugs have recently been implemented on a widespread scale. This rapid progression of brief intervention for drugs other than alcohol has outstripped its evidence base.

The aims of the study as outlined in the grant are:

1. To examine whether BI is effective at improving outcomes (self-reported drug use and attendance in drug abuse treatment) in individuals with a wide range of problem drug use over and above enhanced care as usual. The enhanced control condition will consist of routine screening, patient notification, and referral for treatment.

2. To test whether fidelity to the BI model or lower severity of drug use is associated with better outcomes.

3. To estimate the impact of BI on several public health outcomes that are directly related to the hazardous effects of illicit drug use, including the use of acute health care services, involvement in the criminal justice system, employment, HIV risk behavior, and mortality.

4. To estimate the costs of the intervention, potential cost offsets, and its incremental cost-effectiveness versus enhanced usual care from the payer perspective based on health care service use and drug use frequency.

Study Timeline

• Study Start: 2009-04
• Study First Submitted: 2009-04-06
• Study First Submitted QC: 2009-04-06
• Study First Posted: 2009-04-07
• Primary Completion: 2013-10
• Study Completion: 2014-09
• Status Verified: 2014-10
• Last Update Submitted: 2014-10-17
• Last Update Posted: 2014-10-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 868

Inclusion Criteria

• at least 18 years old
• receive medical care at one of the participating primary care clinics at Harborview Medical Center/University of Washington Medical Center
• will maintain care at the clinic for one year
• have a phone or easy access to phone, voicemail, or email
• used recreational drugs in the last 3 months
• used prescription medications not as prescribed in the last 3 months

Read More

Exclusion Criteria

• participation in any formal substance abuse treatment programs in the last 30 days (excluding 12-step or self-help groups)
• terminal illness

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Brief intervention using motivational interviewing	Brief intervention using motivational interviewing. One in-person session (30-45 minutes) with a brief phone follow-up one week later.

Primary Outcome Measures

Name	Time	Method
Enrollment in formal substance abuse treatment	baseline up to 2 years post-intervention	Enrollment in formal substance abuse treatment will be measured as an admission to chemical dependency treatment as recorded in the Washington State TARGET database.
Use of illicit drugs in the past 30 days	baseline, 3, 6, 9, and 12 months	Use of illicit drugs in the past 30 days will be measured by self-reported days of use in the past 30 days and validated by urine toxicological screen.
Medical, legal, employment, social, and psychiatric outcomes	baseline, 3, 6, 9, and 12 months	Medical, legal, employment, social, and psychiatric outcomes will be measured by composite scores on the Addiction Severity Index (ASI) Lite.

Secondary Outcome Measures

Name	Time	Method
Public health outcomes	baseline up to 2 years post-intervention	Public health outcomes will be measured by administrative data sources (emergency room visits, hospitalizations, hospital days, HIV risk behavior, arrests, and death).
Cost of the intervention	baseline up to 2 years post-intervention	Cost of the intervention will be measured using methods previously employed in the COMBINE study.
Incremental cost-effectiveness	baseline up to 2 years post-intervention	Incremental cost-effectiveness will be measured from the payer perspective based on health care service use and drug use frequency.

Trial Locations

Locations (1)

Harborview Medical Center; 🇺🇸 Seattle, Washington, United States