Brief Intervention in Primary Care for Problem Drug Use and Abuse
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
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:
- 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.
- To test whether fidelity to the BI model or lower severity of drug use is associated with better outcomes.
- 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.
- 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 Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Washington
-
Seattle, Washington, United States, 98104
- Harborview Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
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
Exclusion Criteria:
- participation in any formal substance abuse treatment programs in the last 30 days (excluding 12-step or self-help groups)
- terminal illness
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 1
Brief intervention using motivational interviewing.
One in-person session (30-45 minutes) with a brief phone follow-up one week later.
|
One brief, in-person motivational interviewing session (30-45 minutes) in conjunction with the medical appointment.
Plus one brief follow-up phone call one week later.
|
|
No Intervention: 2
Enhanced care as usual.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Use of illicit drugs in the past 30 days
Time Frame: 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.
|
baseline, 3, 6, 9, and 12 months
|
|
Enrollment in formal substance abuse treatment
Time Frame: 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.
|
baseline up to 2 years post-intervention
|
|
Medical, legal, employment, social, and psychiatric outcomes
Time Frame: 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.
|
baseline, 3, 6, 9, and 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Public health outcomes
Time Frame: 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).
|
baseline up to 2 years post-intervention
|
|
Cost of the intervention
Time Frame: baseline up to 2 years post-intervention
|
Cost of the intervention will be measured using methods previously employed in the COMBINE study.
|
baseline up to 2 years post-intervention
|
|
Incremental cost-effectiveness
Time Frame: 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.
|
baseline up to 2 years post-intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Peter P Roy-Byrne, MD, University of Washington
- Study Director: Kristin Bumgardner, BS, University of Washington
- Study Chair: Antoinette Krupski, PhD, University of Washington
- Study Chair: Richard Ries, MD, University of Washington
- Study Chair: Chris Dunn, PhD, University of Washington
- Study Chair: Dennis Donovan, PhD, University of Washington
- Study Chair: Jutta M. Joesch, PhD, University of Washington
- Study Chair: Gary A. Zarkin, PhD, RTI International
Publications and helpful links
General Publications
- Krupski A, Joesch JM, Dunn C, Donovan D, Bumgardner K, Lord SP, Ries R, Roy-Byrne P. Testing the effects of brief intervention in primary care for problem drug use in a randomized controlled trial: rationale, design, and methods. Addict Sci Clin Pract. 2012 Dec 14;7(1):27. doi: 10.1186/1940-0640-7-27.
- Roy-Byrne P, Bumgardner K, Krupski A, Dunn C, Ries R, Donovan D, West II, Maynard C, Atkins DC, Graves MC, Joesch JM, Zarkin GA. Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical trial. JAMA. 2014 Aug 6;312(5):492-501. doi: 10.1001/jama.2014.7860.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 34892-C
- R01DA026014 (U.S. NIH Grant/Contract)
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