- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03212794
Initiating Substance Use Disorder Treatment for Hospitalized Opioid Use Disorder Patients. (ISTOP)
December 6, 2023 updated by: Joji Suzuki, MD, Brigham and Women's Hospital
The purpose of this 24-week study is to evaluate the impact of recovery coach intervention on rates of treatment retention, illicit opioid use, and readmission among hospitalized patients newly initiated on buprenorphine or methadone compared to the control intervention.
Study Overview
Detailed Description
Patients with opioid use disorder (OUD) frequently utilize hospitals due to soft tissue infections and other conditions that require inpatient level of care.
Prior studies have indicated that OUD patients are often amenable to initiating buprenorphine treatment and can be successfully linked to outpatient treatment.
However, hospitalized OUD patients initiated on buprenorphine have much lower treatment retention rates at 6-months compared to OUD patients initiating treatment in the outpatient setting.
As such, there is a great need to identify strategies to improve treatment retention in this patient population.
There is a growing body of evidence for the benefits of recovery coaches, who provide peer-delivered support services in the community.
Tracing their origin to mutual support groups to supplement traditional clinical services, recovery coaches are individuals with lived experience of recovery.
Studies of recovery coaches have demonstrated greater treatment retention, reduced substance use, and reduced inpatient utilization.
However, no prior studies have examined the impact of recovery coaches in improving medication-assisted treatment retention.
As such, the aim of this 24-week study is to evaluate the impact of recovery coach intervention on rates of treatment retention, illicit opioid use, and readmission among hospitalized patients newly initiated on buprenorphine or methadone compared to the control intervention.
Patients who are successfully initiated on buprenorphine or methadone, and are willing to engage in treatment after discharge, will be eligible to enroll.
Assessments will be conducted at baseline, 4 weeks, 12 weeks, and 24 weeks.
Study Type
Interventional
Enrollment (Actual)
29
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
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Brigham and Women's Hospital
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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
Description
Inclusion Criteria:
- English speaking, adults aged 18-75
- Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) diagnosis of opioid use disorder, severe, actively using illicit opioids until the time of hospitalization
- Have a working telephone
- Can identify at least 2 individuals who can act as points of contact following discharge from the hospital
- Willing to engage in treatment (either a psychosocial treatment program AND/OR medication treatment with methadone or buprenorphine)
Exclusion Criteria:
- Liver function test >3x upper normal limit
- Pregnant
- Psychotic disorder, active suicidality or homicidality
- Condition likely to be terminal in 24 weeks such as cancer
- Unable to perform consent due to mental status
- Engaged in substance abuse treatment in the last month prior to admission
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: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental
Subjects randomized to the experimental arm will be assigned to a recovery coach.In addition to being linked to a community buprenorphine or methadone treatment program, the recovery coach will work to meet weekly with the subject following discharge from the hospital to provide support.
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The recovery coach will support the subjects in the following areas: 1) monitor and manage symptoms, 2) patient education and self-management, and 3) enlisting community and social supports.
Encouragement to continue treatment will be a primary focus of the recovery coach.
In addition, the coach will conduct weekly sessions on various topics and offer personal insights and facilitate a discussion.
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No Intervention: Control
Subjects randomized to the control arm will receive treatment as usual.
This means subjects are linked to ongoing outpatient treatment with buprenorphine or methadone.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Treatment Retention
Time Frame: 24 weeks after baseline
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Primary outcome was retention in MOUD treatment at 6-months after discharge.
If referred to programs affiliated with Brigham and Women's Hospital (BWH), the electronic health records were used to confirm treatment retention.
Otherwise, retention was determined through self-report or confirmation with collateral contacts.
If the electronic health record was not available for confirmation and the participant was lost to follow-up, the missing data was imputed as discontinuation of MOUD treatment.
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24 weeks after baseline
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Readmissions
Time Frame: 24 weeks after baseline
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Percentage of participants experiencing hospital readmission at 6 months.
The electronic health records were used to establish hospital readmission.
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24 weeks after baseline
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Days to Treatment Discontinuation
Time Frame: 24 weeks after baseline
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Number of days until MOUD treatment discontinuation.
If referred to programs affiliated with BWH, the electronic health records were used to confirm treatment retention.
Otherwise, retention was determined through self-report or confirmation with collateral contacts.
If the electronic health record was not available for confirmation and the participant was lost to follow-up, the missing data was imputed as discontinuation of MOUD treatment.
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24 weeks after baseline
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Days to Hospital Readmission
Time Frame: 24 weeks after baseline
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Number of days until hospital readmission.
Electronic health records were used to establish hospital readmission.
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24 weeks after baseline
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Joji Suzuki, MD, Brigham and Women's Hospital
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 (Actual)
February 11, 2019
Primary Completion (Actual)
December 30, 2021
Study Completion (Actual)
December 30, 2021
Study Registration Dates
First Submitted
July 6, 2017
First Submitted That Met QC Criteria
July 6, 2017
First Posted (Actual)
July 11, 2017
Study Record Updates
Last Update Posted (Actual)
December 26, 2023
Last Update Submitted That Met QC Criteria
December 6, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2017P001036
- 1K23DA042326-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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