Brief Intervention in Primary Care for Problem Drug Use and Abuse

October 17, 2014 updated by: Peter Roy-Byrne, University of Washington
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.

Study Overview

Status

Completed

Conditions

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:

  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 Type

Interventional

Enrollment (Actual)

868

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Washington
      • Seattle, Washington, United States, 98104
        • Harborview Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / 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

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

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

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

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

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2009

Primary Completion (Actual)

October 1, 2013

Study Completion (Actual)

September 1, 2014

Study Registration Dates

First Submitted

April 6, 2009

First Submitted That Met QC Criteria

April 6, 2009

First Posted (Estimate)

April 7, 2009

Study Record Updates

Last Update Posted (Estimate)

October 20, 2014

Last Update Submitted That Met QC Criteria

October 17, 2014

Last Verified

October 1, 2014

More Information

Terms related to this study

Other Study ID Numbers

  • 34892-C
  • R01DA026014 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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